Antimicrobial resistance in uropathogen isolates from patients with urinary tract infections

Abstract

Aims: Because of uncontrolled and widespread use of antibiotics, the resistance pattern of uropathogens is changing drastically, specifically in developing countries, such as Bangladesh. The aim of the study was to identify the common Urinary Tract Infection (UTI) causing pathogens in the city of Jessore, Bangladesh and to check the performance of available antibiotics used by those patients. 

Study Design: Random 100 UTI patients who exhibited general UTI symptoms were included in our cross-sectional study. A medical proforma was prepared to input the information associated with the experiment including symptoms of patient’s age, sex, laboratory diagnosis and antimicrobial susceptibility. 

Place and Duration of Study: Department of Microbiology, University of Science and Technology, Jessore 7408 and Pharmacy Discipline, Life Science School, Khulna University, Khulna 9208, Bangladesh, between June 2013 and July 2014. 

Methodology: Urine samples from 100 suspicious urinary tract infected patients were collected as described by Thomson and Miller. Bacterial isolates were tested to identify the bacterial species and to evaluate their antimicrobial susceptibility by Kirby-Bauer disk diffusion technique against some common antibiotics. Epidata® computer program 3.1 and SPSS version 16 statistical software used for confidence interval (CI) and P value, which were defined as P value is <0.05 and CI was set at 95% level of significance for all the proportions. 

Results: Among 100 samples, 74 samples showed positive for cultures adversely responsible for UTIs. About 5 different species of uropathogens were identified from 74 cases. Comparative prevalence of E. coliwas detected in 69 of the 100 samples (69%), while Staphylococcus spp was found in 18 samples (18%), Pseudomonas aeruginosa in 8 samples (8%), and Klebsiella pneumoniae in 6 samples (6%), respectively. Comparative antibiotic resistance profile showed that most of the strains were highly resistant to Amoxicillin (85.14%) and Cotrimoxazole (81.08%). On the contrary, the strains showed significant sensitivity to Amikacin (94.59%), Azithromycin (93.24%), Doxycycline (90.54%), and Ceftriaxone (89.18%), respectively showed significant sensitivity. 

Conclusion: Our results could be helpful to compel rational antibiotic use for UTI. High resistance of uropathogens to antibiotics, such as Amoxicillin and Cotrimoxaxole, has been observed in a significant number of patients in the developing world, such as Bangladesh. Our studies may provoke further investigations into the mechanisms of antibiotic resistance of particular microbes.