Surveillance of multidrug resistant uropathogenic bacteria in hospitalized patients in Indian

https://doi.org/10.1016/S2221-1691(13)60071-4Get rights and content

Abstract

Objective

To record surveillance, antibiotic resistance of uropathogens of hospitalized patients over a period of 18 months.

Methods

Urine samples from wards and cabins were used for isolating urinary tract infection (UTI)-causing bacteria that were cultured on suitable selective media and identified by biochemical tests; and their antibiograms were ascertained by Kirby-Bauer's disc diffusion method, in each 6-month interval of the study period, using 18 antibiotics of five different classes.

Results

From wards and cabins, 1245 samples were collected, from which 996 strains of bacteria belonging to 11 species were isolated, during April 2011 to September 2012. Two Gram-positive, Staphylococcus aureus (S. aureus) and Enterococcus faecalis (E. faecalis), and nine Gram-negative bacteria, Acinetobacter baumannii, Citrobacter sp., Escherichia coli, Enterobacter aerogenes, Klebsiella pneumoniae, Klebsiella oxytoca, Proteus mirabilis, Proteus vulgaris and Pseudomonas aeruginosa were isolated. Both S. aureus and E. faecalis were vancomycin resistant, and resistant-strains of all pathogens increased in each 6-month period of study. Particularly, all Gram-negatives were resistant to nitrofurantoin and co-trimoxazole, the most preferred antibiotics of empiric therapy for UTI.

Conclusions

Antibiograms of 11 UTI-causing bacteria recorded in this study indicated moderately higher numbers of strains resistant to each antibiotic studied, generating the fear of precipitating fervent episodes in public health particularly with bacteria, Acinetobacter baumannii, Escherichia coli, Klebsiella pneumoniae and S. aureus. Moreover, vancomycin resistance in strains of S. aureus and E. faecalis is a matter of concern.

References (44)

  • SL Chen et al.

    Diabetes mellitus and urinary tract infection: Epidemiology, pathogenesis and proposed studies in animal models

    J Urol

    (2009)
  • N Taneja et al.

    Pediatric urinary tract infections in a tertiary care center from Northern India

    Indian J Med Res

    (2010)
  • P Behzadi et al.

    Urinary tract infections associated with Candida albicans

    Maedica

    (2010)
  • E Moreno et al.

    Relationship between Escherichia coli strains causing acute cystitis in women and the fecal E. coli population of the host

    J Clin Microbiol

    (2008)
  • S Manikandan et al.

    Emerging of multidrug resistance human pathogens from urinary tract infections

    Curr Res Bacteriol

    (2011)
  • MM D'Andrea et al.

    Persistent carriage and infection by multidrug-resistant Escherichia coli ST405 producing NDM-1 carbapenemase: Report on the first Italian cases

    J Clin Microbiol

    (2011)
  • JA Karlowsky et al.

    Antimicrobial resistance in urinary tract pathogens in Canada from 2007 to 2009: CANWARD surveillance study

    Antimicrob Agents Chemother

    (2011)
  • C Perrotta et al.

    Oestrogens for preventing recurrent urinary tract infection in postmenopausal women

    Obstet Gynecol

    (2008)
  • SE Geerlings

    Urinary tract infections in patients with diabetes mellitus: epidemiology, pathogenesis and treatment

    Int J Antimicrob Agents

    (2008)
  • RK Baishya et al.

    Urinary tract infection in diabetic patients

    Indian J Nephrol

    (2010)
  • MC Sahu et al.

    Multidrug resistance of Pseudomonas aeruginosa as known from surveillance of nosocomial and community infections in an Indian teaching hospital

    J Publ Health

    (2012)
  • GB Orsi et al.

    Surveillance and management of multidrug-resistant microorganisms

    Expert Rev Anti Infect Ther

    (2011)
  • Cited by (0)

    Foundation Project: Supported by the major research project on Botany (Grant No. 39-388/2010/SR), from UGC, New Delhi, awarded RN Padhy.

    Peer reviewer Dr. Victor D. Rosenthal, MD, MSc, CIC, International Nosocomial Infection Control Consortium (INICC), Corrientes Ave #4580, Floor 11, Apt A, ZIP C1195AAR, Buenos Aires, Argentina. E-mail: [email protected].

    Comments This is a good study in which the authors evaluated antibiogram of notorious UTI causing bacteria isolated from clinical samples of a hospital, for a dreadful disease. Antibiograms of bacteria indicated moderately higher numbers of strains resistant to each antibiotic studied, generating the fear of precipitating fervent episodes in public health particularly with bacteria.

    Available online 28 Apr 2013

    View full text