Prevalence of Antimicrobial Resistance in Uropathogens and Determining Empirical Therapy for Urinary Tract Infections

INTRODUCTION Analyzing antibiotic susceptibility pattern of Uropathogens helps to overcome the therapeutic difficulties created by the emerging antimicrobial resistant bacteria and guides in choosing appropriate empirical therapy. The aim of the study is to understand the susceptibility patterns of the uropathogens which assists in choosing the empirical therapy for UTI. Midstream urine samples were collected cultured and subjected to microscopical and appropriate biochemical tests for proper identification. Antimicrobial sensitivity tests were carried out by disc diffusion technique using Muller Hinton Agar. High level resistance is seen to Cotrimoxazole, Ciprofloxacin, Ceftazidime and Cefipime. Amikacin and Nitrofurantoin were found to be more effective against the isolates. Most of the isolates were sensitive to Imepenem. From our study, Nitrofurantoin is recommended for community acquired UTI and Amikacin for hospital acquired UTI as Empirical treatment. Key-words : Antibiotic resistance, Empirical Treatment,UTI. Infections of the urinary tract are among the most [1, 2.] common infectious diseases in humans Intestine is usually the source of organisms producing [7,8,9]. UTI. Antimicrobial resistance occurs in intestinal bacteria due to antibiotic therapy for treating [8]. infections outside the urinary tract. The use of antibiotics have an influence in the spread of [10,11,12,13,14] antimicrobial resistance among bacteria. The local data about the antimicrobial resistance of Uropathogens should be available for proper therapeutic interventions of UTI. Our study is to analyze the antimicrobial resistance pattern among Uropathogens and to determine the empirical therapy for UTI in community and hospital set up. K.R. Rajesh*, S. Mathavi**, R.Indra Priyadarsini*** MATERIALS AND METHODS A total of 656 urine samples were collected from the out patients and inpatients in our hospital during the study period (Jan2010 – Aug 2010). The mid-stream urine specimens were obtained by clean – catch method. The samples were collected in sterile containers and cultured within one hour of collection. The samples were plated out on MacConkey and Blood agar media and incubated [16-18] aerobically overnight at 37oc. Samples that 5 showed pure growth of isolate in a count of ≥10 colony-forming units (CFU) per ml of urine after overnight incubation were considered to indicate [9] significant bacteriuria. The characteristic bacteria on the culture media were aseptically isolated and subjected to microscopical and appropriate [16]. biochemical tests for proper identification. Antimicrobial sensitivity tests were carried out by disc diffusion technique using Muller Hinton Agar. E. coli ATCC strain 25922 susceptible to all the antibiotics was used as control. The Antibiotics used for susceptibility testing in our study were Cotrimoxazole (COT), Amikacin (AK), Ciprofloxacin (CIP), Ceftazidime (CAZ), Cefipime (CPM), Imepenem (IPM) and Nitrofurantoin (NIT). TABLE : 1 – DISTRIBUTION OF ORGANISM IN IP AND OP