RESISTANCE PATTERNS OF URINARY ISOLATES IN A TERTIARY INDIAN HOSPITAL
AbstractBackground: To analyze the pathogenic organisms recovered from patients with urinary tractinfection in a tertiary Indian hospital setting along with determination of the occurrence and antimicrobial sensitivity of uropathogens on a retrospective basis during a period of one year.Methods : A total of 5073 urine samples were processed. Urine culture was done usingconventional microbiological techniques. Biochemical testing was used to identify the organismsand antibiotic sensitivity was done by the Kirby Bauer method. Results: A total of 2436uropathogens were isolated. E coli were seen in 50.7% samples followed by Klebsiella sp(27.6%). Staphylococcus aureus was the commonest Gram- positive isolate (1.5%). Urinary tractinfection (UTI) was seen in 70.5% females as compared to 29.5% males. A high recovery ofisolates was noted from July to September. Multi drug resistance was commonest withEnterococcus (78.8%) followed by Pseudomonas (65.1%). Drugs, which retained usefulness forGram-negative isolates, were amikacin, norfloxacin and cefotaxime. For Gram-positive isolates,vancomycin, teicoplanin, lincomycin and Norfloxacin were very effective. Conclusions: Ourstudy highlights the changing etiology of UTI and emergence of drug resistance within the Indiansubcontinent.Keywords: Urinary Tract Infections, Pathogens, Antibiotics
Wilkie ME, Almond MK, Marsh FP. Diagnosis and
management of urinary tract infection in adults. BMJ 1992;
Bajaj JK, Karyakarte RP, Kulkarni JD, Deshmukh AB.
Changing aetiology of urinary tract infections and emergence
of drug resistance as a major problem.
J Commun Dis. 1999 Sep;31(3):181-4.
Kass EH. Asymptomatic infections of the urinary tract. Trans
Assoc Am Physicians. 1956, 69:56-64.
Forbes BA, Sahm DF, Weissfeld AS, eds. In: Bailey and
Scott’s Diagnostic Microbiology. 10th Ed. Mosbylnc, Missouri
Bauer AW, Kirby WM, Sh erris JC, Turck M. Antibiotic
susceptibility testing by a standardized single disk method.
Am J Clin Pathol. 1966 Apr;45(4):493-6.
National Committee for Clinical Lab Standards, Performance
Standardization for Antimicrobial Disc Susceptibility test. 4th
ed. Villanona PA. NCC 1993; DC M2 AS.
Tankhiwale SS, Jalgaonkar SV, Ahamad S, Hassani U.
Evaluation of extended spectrum beta lactamase in urinary
isolates. Indian J Med Res. 2004;120(6):553-6.
Chan RK, Lye WC Lee EJ, Kumarasinghe G. Nosocomial
urinary tract infection: a microbiological study.
Ann Acad Med Singapore. 1993;22(6):873-7.
Olafsson M, Kristinsson KG. Sigurdsson JA. Urinary tract
infections, antibiotic resistance and sales of antimicrobial
drugs--an observational study of uncomplicated urinary tract
infections in Icelandic women. Scand J Prim Health Care.
Gupta K, Scholes D, Stamm WE. Increasing prevalence of
antimicrobial resistance among uropathogens causing acute
uncomplicated cystitis in women. JAMA.1999; 281(8):736-8.
Anderson JE. Seasonality of symptomatic bacterial urinary
infections in women. J Epidemiol Community Health. 1983;
Ram S, Gupta R, Gaheer M. Emerging antibiotic resistance
among the uropathogens. Indian J Med Sci 2000; 54(9):388-94.
Mathai E, Grape M, Kronvall G. Integrons and multidrug
resistance among Escherichia coli causing community-acquired
urinary tract infection in southern India. APMIS. 2004;
Farrell DJ, Morrissey I, De Rubeis D, Robbins M, Felmingham
D. A UK multicentre study of the antimicrobial susceptibility
of bacterial pathogens causing urinary tract infection. J Infect .
Iqbal J, Rahman M, Kabir MS, Rahman M. Increasing
ciprofloxacin resistance among prevalent urinary tract bacterial
isolates in Bangladesh. Jpn J Med Sci Biol 1997; 50(6):241-50.
Huovinen P, Cars O. Control of antimicrobial resistance: time
for action. The essentials of control are already well known.