A Study on Prevalence and Antimicrobial resistance pattern of Community acquired gram negative uropathogens at tertiary care teaching hospital , Ahmedabad

BACKGROUND AND OBJECTIVE: Urinary tract infections (UTI) are the common infections in outpatients as well as in hospitalized patients.Antimicrobial resistance remains the major threat due to broad spectrum usage of antimicrobials in community practice. The present study is aimed to determine the prevalence and antibiogramof gram negative uropathogensca using UTI in outpatients of tertiary care teaching hospital, Ahmedabad. METHODS:A total of 2354 urine samples from suspected UTI patients attending to the outpatient clinics and emergency rooms were collected and processed in bacteriology laboratory.Antimicrobial susceptibility testing was performed by modified kirby-bauer disk diffusion method from obtained isolates. Isolates which are resistant to third generation cephalosporins and aztreonamwere tested for extended spectrum beta lactamase (ESBL) production by double disk synergy test. RESULTS:Among 2354 Urine specimens, Significant bacteriuria was seen in 560 (23.79%) specimens. Majority of isolates were from females (59.82%). The most common organisms isolated were Escherichia coli (60.89%), klebsiella spp. (14.11%), pseudomonas spp.(12.68%), followed by Proteus spp.(3.04%).More than 60% of resistance was seen against ampicillin, cephalosporins, cotrimoxazole and ciprofloxacin. More than 97% of the isolates were sensitive to imipenem,while 79.25% were sensitive to amikacin, and 70.25% to nitrofurantoin. Majority of ESBL production was detected in 29.11 % of Klebsiella spp.and26.39% of Escherichia coli isolates. CONCLUSION: E. coli was the predominant isolateduropathogen. Nitrofurantoin should be used as empirical therapy for community acquired UTIs.This study could prove to be useful for clinician to improve the empirictreatment.