Prevalence and antibiotic resistance pattern of urinary tract bacterial infections in Suvekchya International Hospital and Research Centre.

Prevalence and antibiotic resistance pattern of urinary tract bacterial infections in Suvekchya International Hospital and Research Centre Sajana Maharjan, MD Pathologist Suvekchya International Hospital and Research Centre 2016 Approval from NHRC

Abstract:

Background: UTI is the cause of significant morbidity worldwide. The extensive and inappropriate use of antimicrobial agents has invariably resulted in the development of antibiotic resistance that has become a major problem. To ensure appropriate treatment, knowledge of the organisms that cause UTI and their antibiotic susceptibility is mandatory. It is important that physicians are aware which organisms are susceptible to which antibiotics. Isolated pathogen frequency and antimicrobial resistant rates can vary dramatically even within the same nation.

Method: This was a descriptive, cross sectional study, carried out in the clinical laboratory of Suvekchya International Hospital and Research Center which is located in Sitapaila. Convenience sampling was done, as each participant visiting Suvekchya International Hospital and Research Center with symptoms of UTI were referred by the consultant doctor for the urine culture and sensitivity. Urine samples were collected in sterile container provided by the hospital. Patients with positive urine culture were included whereas mixed growth on culture and history of prior antibiotic intake were excluded. Urine specimens were cultured for isolation of microbial agents of urinary tract infection. The isolated bacteria were identified by their cultural characteristics, Gram stain and biochemical reaction. All positive cultures strains were subjected to in vitro susceptibility testing using Kirby Bauer disk diffusion method. Data was collected in structured form which was analyzed using SPSS version 21

Results: Out of a total of 167 urine samples collected from May 2016 to July 2016 33 (19.8%) samples showed significant growth. There were predominately more females with urine culture positive with 69.7% than males, with 30.3%. Mean age was 48.9 years, maximum were in the age group 41 - 50 years with 30.3%. The most common pathogen isolated was E.coli with 69.7% followed by Klebsiella spp. and Pseudomonas aeruginosa. Antimicrobial susceptibility test shows that Amikacin to be most sensitive with sensitivity of 93.9% .Ampicillin was found to be highly resistant showing resistance in 100% of organisms and Amikacin least resistant 6.1%. E.coli and Klebsiella shows 100% sensitivity to Amikacin while Klebsiella also shows 100% sensitivity to Norfloxacin. Klebsiella shows less resistance to antibiotic as compared to E.coli, only Nalidixic acid shows more than 50% resistance. Whereas E.coli shows more than 50% resistance to Cefixime, Ceftriazone, Cotrimoxazole and Cefotaxime and Nalidixic acid showed 47.8% resistance. Pseudomonas showed a very high resistance to antibiotics, with 100% resistance to Ampicillin, Naladixic acid, Norfloxacin and Cotrimoxazole. With 66.7% resistance to other antibiotics expect for Cephazolin with 33.4%.

Conclusion: The most frequently isolated bacteria was E-coli. The most effective antibiotic was Amikacin and the least effective Ampicillin. It is necessary to monitor antimicrobial susceptibility testing to ensure appropriate therapy of UTI.