Bacteriology of Urinary Tract Infection Among the Patients Visiting Tribhuvan University Teaching Hospital (TUTH)
Date
2013
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Department of Microbiology
Abstract
Urinary Tract Infection (UTI) is one of the most common diseases
encountered worldwide and is a major public health problem in terms of
morbidity and financial costs.
A prospective cross-sectional study was carried out from Aug 2012 to Jan
2013 in department of microbiology at TUTH. A total of 1,063 urinary tract
samples (Mid stream urine, catheter, and suprapubic aspirate) from patients
visiting TUTH were included. Samples were processed for routine microscopy
and culture and the organisms were identified by standard microbiological
methods. Antibiotic susceptibility testing was done by Kirby-Bauer Disk
Diffusion method according to CLSI guidelines. ESBL producing organisms
were detected by Combination Disk method, MBL producing organisms were
detected by EDTA-Imipenem combined disk assay and Methicillin resistance
Staphylococcus aureus (MRSA) was detected by Cefoxitin disk.
Of the total 1,063 samples processed, 276(26.0%) samples showed significant
bacteriuria. Twelve different genera of bacteria were isolated from total 276
isolates among which E.coli (57.6%) was the most common isolate followed
by Staphylococcus aureus (14.1%), Klebsiella spp (6.2%), Enterococcus
faecalis (5.4%), Staphylococcus epidermidis (3.9%), Pseudomonas aeruginosa
(3.3%), Acinetobacter spp (2.5%), Enterobacter spp (2.2%), Burkholderia
cepacia Complex (1.8%), Staphylococcus saprophyticus (1.4%), Citrobacter
spp (1.1%) and others (<1%). Among the gram negative isolates (210),
majority (61.0%) of the isolates were found MDR. Nearly 58% of MDR
isolates were ESBL producer and 5% were MBL producers. Most of the
ESBL and MBL producing isolates were detected in E.coli and Klebsiella spp
respectively. Most of the Gram negative bacterial isolates were sensitive to
Polymyxin B followed by Imipenem, Amikacin and Cotrimoxazole. Among
the gram positive isolates (66), 42.4% of isolates were MDR. All the MDR S.
aureus (21/39) isolates were found MRSA. All Gram positive isolates were
sensitive to Vancomycin and Teicoplanin followed by Amikacin. Among the
oral antibiotics tested, Nitrofurantoin was found to be the most sensitive
antibiotic for gram positive as well as gram negative bacterial isolates.
It revealed that E. coli is the predominant Uropathogens in TUTH, Nepal.
There is an increasing resistance to many antibiotics in the both community
and hospital settings. Now-a- days, ESBL and MBL producing uropathogens
are emerging.
Keywords: Antimicrobial Susceptibility Profile, ESBL, MBL, MDR,
MRSA, UTI
Description
Keywords
Antimicrobial Susceptibility Profile, ESBL, MBL, MRSA