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Antibiogram of Gram Negative Uropathogens in a Tertiary Care Hospital

Background: Globally, urinary tract infection (UTI) is considered a major public health concern and the second most common bacterial infection affecting individuals of different ages worldwide. Urinary tract infections (UTIs) are caused by multiplicity of microorganisms. The chronicity of different bacterial isolates and their propensity to various antibiotics may differ widely, particularly in hospitalized patients, that makes the study of susceptibility pattern mandatory for a proper selection of antibiotics. Objective: To evaluate antimicrobial susceptibility pattern of the Gram negative organisms isolated from urine cultures of hospitalized patients. 
Material and Methods: A total of 500 urine samples from hospitalized patients which showed significant bacteriuria were studied. Samples were inoculated on Blood agar and MacConckey agar. Further identification and study of organisms was done by standard Microbiological methods. Antimicrobial Susceptibility pattern was studied by Modified Kirby- Bauer’s disc diffusion method with the panel of 15 drugs as per Clinical Laboratories Standard Institute (CLSI) guidelines. Results: UTIs were found more common in females 290 (58%). Commonest organism found was Escherichia coli 260 (52%) followed by Klebsiella spp. 120 (24%), Pseudomonas spp. 40 (8%), Proteus spp. 38 (7.6%), Citrobacter spp. 25 (5%) and Acinetobacter spp. 17 (3.4%). Majority of the strains were found sensitive to nitrofurantoin followed by amikacin, piperacillin-tazobactam and cotrimoxazole. Commonly prescribed fluroquinolones were found least effective for treatment of UTI. All the strains were found sensitive to imipenem. Extended spectrum beta lactamase (ESBL) was noted in E.coli and in Klebsiella spp. Conclusion: To discourage the indiscriminate use of antibiotics and to prevent further development of bacterial drug resistance, proper knowledge of susceptibility pattern of uropathogens in particular area is very important before prescribing any empirical antibiotic therapy.