TRENDS IN ANTIMICROBIAL RESISTANCE AMONG COMMON ISOLATES OF URINARY TRACT INFECTION IN TERTIARY CARE HOSPITAL OF NEPAL

Abstract

Background: Urinary Tract Infection (UTI) is the most common infection in both community and hospital setting, in all age group with frequently occurring in female. The increasing pattern of the Multi Drug Resistance (MDR) among urinary isolates posses the significant problem in public health worldwide. Therefore, this study aims to assess the MDR and Antimicrobial Susceptibility Test (AST) pattern of bacterial isolates in our setting. Methods: Retrospective study of 2080 patients suspected for UTI attending Manmohan Memorial Community Hospital from 1st March 2011 to 30th February 2013 was done. Specimens were collected aseptically, cultured, identified and AST was done by standard methodology. Results: Of total, (557, 26.25%), with female to male ratio of about 3:1 showed the significant growth. Majority of the organism were Gram negative (478, 87.54%) with the most common pathogen Escherichia coli (78.63%). In total 305 (55.86%) of urinary isolates were MDR. Among the top three common Gram negative urinary isolates the maximum MDR was found in Proteus spp. (100%) followed by Klebsiella spp. (73.53%). Among Gram positive isolates 46.99% MDR was found in Staphylococcus spp. In comparison of tested antibiotic gentamicin followed by ciprofloxacin for the top three Gram negative and gentamicin followed by nitrofurantoin for the Gram positive urinary isolates were the most effective antibiotics. Conclusions: The most common causative organism for UTI was E. coli with maximum MDR in Proteus spp. and the appropriate antibiotic in vitro was gentamicin in this study. Higher resistance was found in antibiotics such as amipicllin, cotimioxazole, cephalexin, nalidixic acid and norfloxacin.