Antibiotic susceptibility patterns of bacteria isolated from patients with community acquired urinary tract infections.

Article Information

Title: Antibiotic susceptibility patterns of bacteria isolated from patients with community acquired urinary tract infections.

Authors: Rabia Ali

Journal: The Professional Medical Journal (TPMJ)

HEC Recognition History

Category	From	To
Y	2024-10-01	2025-12-31
Y	2023-07-01	2024-09-30
Y	2022-07-01	2023-06-30
Y	2021-07-01	2022-06-30

Publisher: Independent Medical College, Faisalabad- Pakistan

Country: Pakistan

Year: 2023

Volume: 30

Issue: 11

Language: English

DOI: 10.29309/TPMJ/2023.30.11.7883

Keywords: Antibiotic resistanceUrinary tract infectionsMulti-drug resistant bacteriaCommunity-acquired InfectionsUro-Pathogenic Bacteria

Abstract

Objective: The emergence of multi-drug resistant uro-pathogenic bacteria has negatively impacted the treatment of urinary tract infections. The objective of this study was to identify the rising rates of resistance of uro-pathogenic bacteria to antimicrobials. Study Design: Retrospective Analysis of Bacteria Isolated from urine cultures of adult outpatients with complicated or long-term urinary tract infections was done. Setting: Out- patient Clinics of Independent University Hospital, An Urban Tertiary Care Teaching Hospital in Faisalabad. Period: July 2021 to July 2022. Material &amp; Methods: Urine samples from patients advised urine cultures after presenting with symptoms of urinary tract infections were included using convenience sampling technique. Results: The most common etiologic agent isolated was E.coli, followed by Klebsiella, Pseudomonas and Staphylococcus saprophyticus. The drugs with the highest susceptibility were ciprofloxacin (56.3%), nitrofurantoin (53.1%), and imipenem (44.8%). Nalidixic acid (40.6%), sulfamethoxazole-trimethoprim (37.5%), and erythromycin (25%) had low efficacy, while penicillin G and co-amoxiclav failed to work on all bacterial isolates in this study. Conclusion: The rising rates of resistance of uro-pathogenic bacteria to multiple drugs indicate the employment of good antibiotic stewardship practices by clinicians in outpatient clinics, to decrease the burden of infections in the communities.

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Research Objective

To identify the rising rates of resistance of uro-pathogenic bacteria to antimicrobials in patients with community-acquired urinary tract infections.

Methodology

Retrospective analysis of urine cultures from adult outpatients with complicated or long-term urinary tract infections. Samples were collected from July 2021 to July 2022 at Independent University Hospital, Faisalabad. Standard Kirby-Bauer disc diffusion method was used for antibiotic susceptibility testing, with results interpreted based on CLSI guidelines.

Methodology Flowchart

                        graph TD;
    A["Collect urine samples from adult outpatients with UTI symptoms"] --> B["Process samples for bacterial culture"];
    B --> C["Identify bacterial isolates"];
    C --> D["Perform antibiotic susceptibility testing"];
    D --> E["Analyze susceptibility data"];
    E --> F["Identify common pathogens and resistance patterns"];
    F --> G["Draw conclusions on antibiotic effectiveness"];
    G --> H["Recommend antibiotic stewardship practices"];

Discussion

The study highlights a significant rise in antibiotic resistance among uropathogens, particularly E. coli, to commonly used first-line agents. This necessitates improved antibiotic stewardship practices in outpatient clinics to combat the growing burden of drug-resistant infections.

Key Findings

E. coli was the most common etiologic agent, followed by Klebsiella, Pseudomonas, and Staphylococcus saprophyticus. Ciprofloxacin (56.3%), nitrofurantoin (53.1%), and imipenem (44.8%) showed the highest susceptibility. Penicillin G and co-amoxiclav failed to work on all bacterial isolates. E. coli showed 100% resistance to penicillin G and co-amoxiclav.

Conclusion

The increasing rates of resistance to multiple drugs by uropathogenic bacteria underscore the urgent need for clinicians to implement good antibiotic stewardship practices in outpatient settings to reduce the prevalence of infections and the emergence of drug-resistant bacteria in the community.

Fact Check

* The study period was from July 2021 to July 2022. (Confirmed in text)
* E. coli was the most common etiologic agent isolated. (Confirmed in text)
* Penicillin G and co-amoxiclav showed 0% susceptibility. (Confirmed in text)

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