Urinary tract infections : a community study from suburban mumbai

Abstract

AIM: Study of bacterial isolates from urine samples with their antimicrobial sensitivity pattern from patients attending the outpatient department of suburban clinics. Methods: Urine samples were processed on routine media, the isolates obtained were identified and sensitivity was obtained by an automated analyser. Results: Of 755 urine samples 205 (27.15%) showed no growth in culture, 155 (20.5%) samples grew more than 3 colonies i.e. polymicrobial flora suggestive of contamination, 82 (10.9%) urine grew insignificant growth of gram negative bacilli. Majority of the uropathogens were gram negative bacilli (74.1%) followed by gram positive cocci (23.6 %) and fungal isolates were (2.2%). The gram positive isolates were sensitive to most of the drugs tested like Nitrofurantoin (100 %) Tigecycline (100%) Vancomycin (100%) Linezolid (100%) Gentamicin (82-100%) Levofloxacin showed (83-91%) for Staphylococcus aureus & CONS. Enterococcal strains were highly resistant to Levofloxacin and Cotrimoxazole. CONS were highly resistant to Ampicillin. All the gram positive isolates showed decreased sensitivity to Ciprofloxacin (23-41%). The E.coli strains were highly sensitive to Amikacin (100%) Imipenem (97%) Colistin (97%) Nitrofurantoin (89.6%) Piperacillin-tazobactam (83%) Tobramycin (83%) and showed moderate sensitivity to Gentamicin (69%) Cefipime (66%) Ampicillin sulbactam (58%) Ceftriaoxone (55%) Ciprofloxacin (51%) Cotrimoxazole (51%)and resistant to Ampicillin. The Klebsiella isolates were highly sensitive to Amikacin (100%) Imipenem (100%) Piperacillin tazobactam (100%) Colistin (92%) Gentamicin (84%) Tobramycin (84%) Ampicillin-Sulbactam(80%) Cotrimoxazole (78%) Ciprofloxacin (73%) and moderately sensitive to Cefipime (52%) Ceftriaoxone (50%). Conclusion:Urinary tract infections are amongst the commonest infections encountered in clinical practice. This article highlights the importance of urine culture and sensitivity as one of the gold standards for the effective treatment and for avoiding irrational use of antimicrobials to reduce the growing resistance in the community and thereby prevent the emergence of highly resistant bacterial strains within the community and ensure judicious use of these agents.