Study on the Antimicrobial Sensitivity of Urinary Micro- Organisms in Diabetics with Urinary Tract Infection”

OBJECTIVE: To study the frequency of urinary culture isolatesin diabetics with urinary tract infection and to compare the spectrum ofin vitrosensitivity to commonly used anti-microbial agents. RESEARCH DESIGN AND METHODS: This was a retrospective study done over a year, by procuring data from the patient records of diabetics admitted with urinary tract infection. The clinical settings including history, examination and the urine cultures with anti-microbial sensitivity of 40 patients were included in the study. The procured data were further analyzed using ratios and percentages. RESULTS:In this study, 37 patients had isolates of a single organism and 3 had multiple isolates. Escherichia coli was the most common among all isolates (67.5%). Among other isolated organisms were Enterococcus12.5%, Klebsiella 10%, Acinitobacter 5 %, Candida 5%, Pseudomonas 5% and Proteus 2.5%.Similar pattern was observed among patients with chronic kidney disease.IncidenceofE coli isolates in recurrent UTI was much lower (13.33%) as compared to Enterococcus (20%). When analyzed based on prior antimicrobial exposure, 80% of isolates were Enterococcus and 20% were Acinitobacter. We observed 70% resistant organisms to common antibiotics such as Ampicillin, Nitrofurantoin, Ceftriaxone, Ciprofloxacin and Levofloxacin. However, most were sensitive to Carbepenems and Piperacillin plus Tazobactam. The resistant strains were often isolated in patients with higher glycosylated Hb indicating poorlycontrolled diabetes mellitus. CONCLUSIONS: The current study found E. Coli to be the most common urinary isolate. It showed resistance to commonly prescribed oral antibiotics.The practice of developing an anti-microbial policy in individual hospitals based on their antibiograms could prevent the emergence of multidrug resistant micro-organisms.