Profile of Bacterial Uropathogens and Their Antibiotic Susceptibility Patterns in Clinically Suspected Cases of Urinary Tract Infections in A Rural Hospital in Haryana, India

Monitoring of antimicrobial resistance pattern and bacterial profile of uropathogens can help clinicians choose empiric therapy for urinary tract infections. Therefore, the present study was carried out to establish current antimicrobial resistance pattern and its correlation with various demographic parameters. A hospital based prospective observational study was conducted from October 2014 to May 2015 to find out the causative organisms of urinary tract infections and to determine antimicrobial susceptibility pattern of the uropathogens. Mid-stream “clean catch” urine samples from 500 clinically-suspected cases of urinary tract infections were processed bacteriologically using standard procedures. Antimicrobial susceptibility testing of the uropathogens showing significant count was performed by using Kirby-Bauer disk diffusion method and results interpreted according to Clinical and Laboratory Standards Institute guidelines. Of 500 urine samples, significant growth of bacteria was detected in 95(19%) of samples. Among the 95 positive samples, Escherichia coli (44.2%) was the most common uropathogen, followed by Klebsiella pneumoniae (17.8%), Proteus mirabilis (7.4%), Staphylococcus aureus (7.4%), Pseudomonas aeruginosa (7.4%), Acinetobacter baumanii (5.3%), Citrobacter spp. (4.2%), S. saprophyticus (4.2%) and Enterococcus faecalis (2.1%). All the isolates showed maximum resistance to ampicillin and co-trimoxazole and least resistance to nitrofurantoin, amikacin, imipenem and vancomycin. Among E. coli and K. pneumoniae isolates, 30.9% and 29.4% respectively were suggestive of ESBL production. Among S. aureus, 18.4% were found to be Methicillin Resistant S. aureus (MRSA). Many pathogens have shown resistance to antibiotics which have been sensitive earlier and were considered for the treatment of UTIs such as co-trimoxazole and nalidixic acid. So, regular monitoring of antibiotic resistance is required to establish reliable information about the most effective empirical antibiotic treatment of UTIs.