Antimicrobial Sensitivity Patterns of Uropathogens: Are Antibiotics Losing Their Cutting Edge?
Abstract
Objective: To assess the antimicrobial resistance patterns in commonly isolated urinary pathogens by using laboratory-based urine culture data.
Material and methods: It is a non-interventional retrospective observational study conducted on data extracted from the laboratory-based in multiple locations, including Mumbai, Thane, Pune, and Goa. All positive urine culture done in the laboratories between January 2016 and September 2017 were included in the study. Data was analyzed using Microsoft Excel, and R. Culture sensitivities were described in the form of proportions.
All samples reported as intermediate or resistant were considered as resistant. In order to maintain confidentiality, deidentified personal information and anonymized data has been used.
Results: The overall sample size of the study was 8170, out of which 73.2% of the samples were from females.
Overall, E. coli was the most common isolate, followed by Klebsiella pneumoniae, Pseudomonas aeruginosa, and Proteus mirabilis. Elderly contributed most to the culture positive UTIs in comparison to other age groups. Females in age group 18-45 years have a considerably higher burden of culture-positive UTIs than males (30.8% vs. 12.2%). Whereas, males have a higher proportion of Pseudomonas isolates than females (13.3% vs. 4.5%). The overall sensitivity of urinary isolates was inferior (<50%) for a second (Cefuroxime) and third-generation cephalosporins (Ceftriaxone, Cefotaxime, Cefixime). Sensitivity to fluoroquinolones (Ciprofloxacin, Levofloxacin, Norfloxacin) is less than 50%. E. coli was least sensitive for fluoroquinolones in comparison to other bacterial isolates. Cotrimoxazole has overall ~50% coverage against urinary isolates. In addition, E. coli demonstrated high sensitivity against carbapenems, fosfomycin, and nitrofurantoin but
poor sensitivity for cephalosporins, penicillins, and fluoroquinolones.
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