A prospective study of antibiotic susceptibility pattern of uropathogens in a tertiary care hospital

Background: Urinary tract infection (UTI) is a frequent condition encountered in primary care. Treatment is usually empirical without urine culture and susceptibility testing because the causative uropathogens and their antimicrobial susceptibility profiles are considered to be predictable. However, there is increasing evidence of antimicrobial resistance in community- acquired uropathogens. This study aimed to assess the prevalence and antimicrobial susceptibility pattern of uropathogens causing UTI. 

Methods: A prospective study was conducted over a period of six months in a tertiary care hospital in Kerala, India. A total of 100 patient case records satisfying the inclusion criteria were analysed to determine the prevalence of uropathogens causing UTI and also to determine antibiotic sensitivity pattern of uropathogens to various antibiotics. All the relevant and necessary data of the patient were collected from patient’s case record and microbiology department to study the rational prescribing of antibiotics before and after culture sensitivity test. Data analysis was conducted using Chi-squared test and descriptive statistics.

Result: In this study, we observed a higher incidence of UTIs in females, particularly among individuals aged over 70 years. The primary microorganisms isolated from these cases were Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa. Upon conducting culture sensitivity tests, approximately half of the initially prescribed antibiotics were altered. Penicillin class of antibiotic was frequently substituted, predominantly with drugs from the carbapenem class. Our analysis of antibiotic sensitivity revealed that Imipenem exhibited the highest sensitivity, followed by meropenem and colistin within our study cohort. 

Furthermore, a chi-square test was conducted, yielding a chi-square value of 12.25 with a p-value less than 0.001, implies that there is a significant difference between drugs given before and after C/S was done. These findings underscore the importance of tailored antibiotic selection based on microbial sensitivity profiles, especially in elderly female patients, to ensure effective treatment outcomes for UTIs.

Conclusions: According to the research, UTIs are the most common public health issue, primarily affecting women. Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosawere the most common isolated organisms in our study that caused UTIs in IndiaMost isolates exhibited resistance to widely used antibiotics.Thus, regular surveillance and monitoring are essential for improved patient care.