Epidemiological study of antimicrobial resistance patterns of suspected urinary tract infections in a super surgical, super speciality hospital in Northern India

Background: This study aimed to assess the antimicrobial resistance profiles of urinary tract infection (UTI) collected from individuals of various age groups, both male and female.

Methods: A total of 266 urine samples from a diverse range of individuals were included in this investigation. Midstream urine (MSU) specimens were collected and promptly transported to the laboratory. Within two hours of collection, these samples were processed on Cysteine Lactose Electrolyte Deficient (CLED) medium. Following bacterial growth on the culture medium, species identification was carried out based on colony morphology, Gram staining, and biochemical characteristics. Antimicrobial susceptibility testing, Extended Spectrum β - Lactamase (ESBL) detection, and Carbapenemase detection were performed using the VITEK 2 Compact system (Biomerieux, France).

Results: A total of 61 (22.93%) significant UTIs were identified in both male and female patients. These UTIs were caused by 48 (78.69%) gram-negative bacteria, 7 (11.48%) gram-positive bacteria, and 6 (9.84%) Candida species. Escherichia coli was the predominant bacterium among all the uropathogens isolated (37.70%), followed by Klebsiella pneumoniae (26.22%) and Pseudomonas aeruginosa (11.47%). The overall antibiotic susceptibility patterns revealed that tetracycline exhibited the highest resistance rate (88.89%) among all the gram-negative and gram-positive uropathogens, followed by ceftriaxone (77.14%). The most effective drugs were found to be amikacin (89.36%) and colistin (97.30%) against both gram-negative and gram-positive uropathogens. Notably, colistin susceptibility was observed exclusively in cases of multidrug resistance (MDR) and pandrug resistance (PDR).

Conclusions: This study indicates that gram-negative bacteria, particularly E. coli, are responsible for a higher number of UTIs compared to gram-positive uropathogens. Amikacin and colistin were identified as the most effective antibiotics against both gram-negative and gram-positive uropathogens.