A study to evaluate the species and antibiotic sensitivity pattern of urinary tract pathogens.

Abstract

Aim: To determine prevalence of uropathogenic bacteria and their antibiotic susceptibility pattern along with detection of extended spectrum β-lactamase (ESBL) production in Escherichia coli and Klebsiella spp. and methicillin resistance in Staphylococcus aureus (MRSA). Materials and Methods: 250 urine specimens received in microbiology lab from suspected UTI patients attending to the outpatient department were processed by standard techniques. ESBL production was determined by double disc synergy test and phenotypic confirmatory method. Results: Of 250 samples 20.8% showed significant bacteriuria, higher in females (61.5%). Escherichia coli was the predominant uropathogen (35%), followed by coagulase negative Staphylococcus (10.6%), Klebsiella spp. (10.2%). Gram negative bacilli showed maximum sensitivity to nitrofurantoin (68.9%), amikacin (62.2%) and gram positive cocci showed maximum sensitivity for nitrofurantoin (83.5%) followed by vancomycin (79.7%), gentamicin (75.9%). High resistance was seen against ampicillin, nalidixic acid, co-trimoxazole, cephalexin and norfloxacin. Prevalence of ESBL in Escherichia coli and Klebsiella spp. and MRSA was found to be 45.3%, 40% and 70% respectively. Conclusion: Escherichia coli was the predominant uropathogen for community acquired UTIs in Udaipur, Rajasthan. Uropathogens showed resistance to commonly used antibiotics with increasing trend of ESBL production and methicillin resistance. Nitrofurantoin, vancomycin should be used as empirical therapy. The susceptibility and resistance patterns of uropathogens should be considered before starting empiricaltreatment.

Keywords: Antibiotic Susceptibility, Escherichia coli, ESBL, MRSA, Staphylococcus aureus Urinary Ttract Infections (UTIs).