Antibiogram Profile of Patients Having Urinary Tract Infection Treated with Most Commonly Used Antibiotics
DOI:
https://doi.org/10.36283/ziun-pjmd14-1/016Keywords:
Escherichia Coli, Uropathogens, Antibiotic, Multi-Drug Resistant, Urinary Tract InfectionAbstract
Background: Urinary tract infections (UTIs) are the most common infections in humans, primarily caused by bacteria, with Escherichia coli (E. coli) responsible for 75-90% of cases. The rise in bacterial resistance is largely due to inappropriate antibiotic use, posing significant public health concerns. This study investigated UTI prevalence and antibiotic resistance to inform optimized treatment guidelines. This study aimed to identify the bacterial pathogens causing UTIs and assess their antimicrobial sensitivity and resistance to commonly used antibiotics.
Method: A descriptive cross-sectional study was conducted over six months at Khyber Teaching Hospital's Microbiology Department to assess the antibiogram profile of uropathogens from urine cultures. Urine samples were cultured on CLED media, and biochemical tests were used to identify the uropathogens. Antimicrobial susceptibility testing was performed on the isolates using the Kirby-Bauer disk diffusion method on Mueller Hinton Agar (MHA), following CLSI guidelines. A total of 384 patients' urine samples were collected through a convenient technique and processed as per standard guidelines. The collected data was analyzed using SPSS-22 and shown in tables.
Results: Escherichia coli was the most common uropathogen, found in 48.17% (n=185) of cases, with a higher prevalence in females at about 48.4% (n=125). Fosfomycin was the most frequently prescribed antibiotic (31.5%) and showed the highest sensitivity (50.2%). Cefotaxime exhibited the highest resistance (38.45%), followed by Amoxicillin-clavulanic acid (34.8%).
Conclusion: Escherichia coli remains the dominant pathogen, with Fosfomycin proving generally effective, while resistance to cefotaxime is notable. These reports show the importance of antibiotic use responsibly. By selecting appropriate antibiotics, we can minimize the resistance rate of uropathogens.
References
Kaur R, Kaur R. Symptoms, risk factors, diagnosis and treatment of urinary tract infections. Postgraduate medical journal. 2021;97(1154):803-12. DOI: 10.1136/postgradmedj-2020-139090
Kanda N, Hashimoto H, Sonoo T, Naraba H, Takahashi Y, Nakamura K, et al. Gram-negative organisms from patients with community-acquired urinary tract infections and associated risk factors for antimicrobial resistance: a single-center retrospective observational study in Japan. Antibiotics. 2020;9(8):438. Doi: 10.3390/antibiotics9080438
Chooramani G, Jain B, Chauhan PS. Prevalence and antimicrobial sensitivity pattern of bacteria causing urinary tract infection; study of a tertiary care hospital in North India. Clinical Epidemiology and Global Health. 2020;8(3):890-3. doi.org/10.1016/j.cegh.2020.02.018
Anwar HAH, Yousaf AYA, Khalid HKH, Chaudhary SCS, Raza ABRAB, Tahir MTM. Spectrum of organisms causing urinary tract infection (uti) in children in tertiary care hospital. Journal of Akhtar Saeed Medical & Dental College. 2022;4(04). https://amdc.edu.pk/Ojs/ojs-3.3/index.php/jamdc/article/view/215
Sujith S, Solomon AP, Rayappan JBB. Comprehensive insights into UTIs: from pathophysiology to precision diagnosis and management. Frontiers in Cellular and Infection Microbiology. 2024;14:1402941. doi.org/10.3389/fcimb.2024.1402941
Seid M, Markos M, Aklilu A, Manilal A, Zakir A, Kebede T, et al. Community-acquired urinary tract infection among sexually active women: risk factors, bacterial profile and their antimicrobial susceptibility patterns, Arba Minch, Southern Ethiopia. Infection and drug resistance. 2023:2297-310. DOI: 10.2147/IDR.S407092
Ramzan M, Raza A, un Nisa Z, Abdel-Massih RM, Al Bakain R, Cabrerizo FM, et al. Detection of antimicrobial resistance (AMR) and antimicrobial susceptibility testing (AST) using advanced spectroscopic techniques: A review. TrAC Trends in Analytical Chemistry. 2024;172:117562. doi.org/10.1016/j.trac.2024.117562
Islam MA, Islam MR, Khan R, Amin MB, Rahman M, Hossain MI, et al. Prevalence, etiology and antibiotic resistance patterns of community-acquired urinary tract infections in Dhaka, Bangladesh. Plos one. 2022;17(9):e0274423. DOI: 10.1371/journal.pone.0274423
Ali S, Khalid H, Muhammad N, Shuaib SL, Muhammad A. Frequency of bacterial isolates and antibiotics resistance patterns in urine and pus samples. The Professional Medical Journal. 2021;28(11):1571-7. DOI:
https://doi.org/10.29309/TPMJ/2021.28.11.5987
Eshwarappa M, Dosegowda R, Aprameya IV, Khan M, Kumar PS, Kempegowda P. Clinico-microbiological profile of urinary tract infection in south India. Indian journal of nephrology. 2011;21(1):30-6. doi: 10.4103/0971-4065.75226
Sana F, Tayyab N, Shujaat U, Iqbal H, Ahsan J. Antimicrobial susceptibility pattern of common bacterial uropathogens, a comprehensive study at tertiary care Hospital of balochistan. Pakistan Journal of Pathology. 2023;34(3):89-95. Doi.org/10.55629/pakjpathol.v34i3.768
Sharma P, Netam AK, Singh R. Prevalence and in vitro antibiotic susceptibility pattern of bacterial strains isolated from tribal women suffering from urinary tract infections in District Anuppur, Madhya Pradesh, India. Biomedical Research and Therapy. 2020;7(8):3944-53. Doi.org/10.15419/bmrat.v7i8.625
Ahmed SK. Research Methodology Simplified: How to Choose the Right Sampling Technique and Determine the Appropriate Sample Size for Research. Oral Oncology Reports. 2024:100662. Doi.org/10.1016/j.oor.2024.100662
Potter RF, Wallace MA, Muenks CE, Alvarado K, Yarbrough ML, Burnham C-AD. Evaluation of Variability in Interpretation of Disk Diffusion Testing for Cefiderocol Using Different Brands of Mueller–Hinton Agar. The journal of applied laboratory medicine. 2023;8(3):523-34. DOI: 10.1093/jalm/jfac131
Hossain A, Hossain SA, Fatema AN, Wahab A, Alam MM, Islam MN, et al. Age and gender-specific antibiotic resistance patterns among Bangladeshi patients with urinary tract infection caused by Escherichia coli. Heliyon. 2020;6(6). Doi: 10.1016/j.heliyon.2020.e04161
Idrees MM, Rimsha R, Idrees MD, Saeed A. Antimicrobial susceptibility and genetic prevalence of extended-spectrum β-lactamases in gram-negative rods isolated from clinical specimens in Pakistan. Antibiotics. 2022;12(1):29. DOI: 10.3390/antibiotics12010029
Hassni MA, Hussain A, Rahman MZU, Khan MS, Iftikhar H, Hasni K, et al. Antimicrobial Resistance Patterns of Urine Culture in Tertiary Care Teaching Hospital Islamabad, Pakistan. National Journal of Life and Health Sciences. 2022;1(2):33-7. DOI:
62746/njlhs.v1n2.27
Muhammad A, Khan S, Ali N, Rehman M, Ali I. Prevalence and antibiotic susceptibility pattern of uropathogens in outpatients at a tertiary care hospital. New Microbes and new infections. 2020;36:100716. doi: 10.1016/j.nmni.2020.100716
Ullah S, Khan SA, Iftikhar SH, Shah T, Osama M, Ullah I, et al. Emerging Antibiotic Resistance Profiles in Urinary Tract Infections Among the Elderly: A Critical Review. International journal of health sciences.8(S1):648-62. doi.org/10.53730/ijhs.v8nS1.14875
Muhammad A, Ali N, Ali S, Shuaib SL, Afridi IQ, Saeed W, et al. Antibiotics resistance of extended spectrum beta lactamases uropathogenic Escherichia coli in Peshawar-Pakistan. Pure and Applied Biology (PAB). 2020;9(3):1840-8. http://dx.doi.org/10.19045/bspab.2020.90196
Khalil A. Prevalence and antibiogram of uncomplicated lower urinary tract infections in human population of Gilgit, Northern Areas of Pakistan. Pakistan Journal of Zoology. 2008;40(4). http://zsp.com.pk/pdf2/295-301%20(10).pdf
Joya M, Aalemi AK, Baryali AT. Prevalence and antibiotic susceptibility of the common bacterial uropathogen among UTI patients in French Medical Institute for Children. Infection and drug resistance. 2022:4291-7. DOI: 10.2147/IDR.S353818
Akhtar MS, Mohsin N, Zahak A, Ain MR, Pillai P, Kapur P, et al. Antimicrobial sensitivity pattern of bacterial pathogens in urinary tract infections in South Delhi, India. Rev Recent Clin Trials. 2014;9(4):271-5. DOI: 10.2174/1574887109666141127104220
Ahmad S, Ali F, Qureshi SA, Uzma B, Shakeela Q, Sabir MS, et al. The evaluation of antibiotic susceptibility pattern and associated risk factors of UTI in tertiary care hospital of Peshawar. Pak J Pharm Sci. 2022;35(3):897-903. https://pubmed.ncbi.nlm.nih.gov/35791585/
Khan IU, Mirza IA, Ikram A, Afzal A, Ali S, Hussain A, et al. Antimicrobial susceptibility pattern of bacteria isolated from patients with urinary tract infection. J Coll Physicians Surg Pak. 2014;24(11):840-4. https://pubmed.ncbi.nlm.nih.gov/25404444/
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