Study on clinico microbiological profile and antibiotic susceptibility pattern of urinary tract pathogens with Special reference to susceptibility of Escherichia coli to fosfomycin

Urinary tract infections (UTI) is the most common infection seeking medical attention. Most of UTI cases were treated empirically with broad-spectrum antibiotics which invariably resulted in development of resistance even to carbapenem. Fosfomycin has broad spectrum of activity which may be useful against these resistant pathogens. Study aims to address microbiological profile, susceptibility pattern of UTI pathogens and fosfomycin susceptibility against all urinary isolates of Escherichia coli (E.coli)

All urine samples received in our central laboratory over a period of 2 months (May-June 2017) which showed significant growth were included in the study. After getting the written informed consent, data was collected using a questionnaire regarding demographic and clinical details. In vitro susceptibility of fosfomycin carried out for all E.coli. Among 1280 samples, only 156 (12.2%) yielded significant growth which emphasises the importance of urine culture for definite diagnosis of UTI. Females and >50 years of both gender showed higher prevalence. Majority of cases from medicine ward (41.7%) and ICU (23.1%) with diabetes (55.1%), catheter (34.6%) was common predisposing factor. E.coli (63.2%) was the predominant organism followed by Candida (11.6%) which has become an emerging threat. Higher resistance pattern seen with catheterised group. 40.4% were extended spectrum beta lactamase (ESBL), 12.8% inducible AmpC and 29.8% carbapenamases producers. All E.coli isolates including ESBL, carbapenamase producers showed susceptible to fosfomycin.

Study emphasis evidence based practice is the need of hour to combat with raising resistant pattern. Fosfomycin shown promising results to all ESBL and carbapenamase producing E.coli.