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Current Antibiotic Resistance Pattern of Prevalent Uropathogens in Urinary Tract Infection of Diabetic Patients in Comparison with non-Diabetics

Introduction: Urinary tract infections (UTIs) are a common infectious disease worldwide. Bacterial resistance to antibiotics is one of the most challenging global health problems. Regional surveillance programs are necessary to update knowledge on antimicrobial resistance patterns for empirical antibiotic treatment of the patients. This study aimed to explore the bacteriology and antibiotic resistance pattern of urological pathogens in diabetic patients compared to that in non-diabetics. Materials and Methods: A prospective study during the period from June 2021 to November 2021 in Khulna City Medical College Hospital was carried out including 347 diabetic and non-diabetic patients. Midstream clean-catch urine samples were collected from suspected UTI patients of age more than 14 years and inoculated in Mac Conkey & Blood agar media for semi-quantitative urine culture and sensitivity test. Antibiotic susceptibility test was done by Kirby-Bauer disc diffusion method following clinical laboratory science (CLS) program. Results: Among the 347 inoculated samples, Culture positive were in 286 cases. Gram-negative E. coli was isolated from 119 (overall 41.6%, 51% in diabetics and 36.5% in non-diabetic patients) samples which were the most predominant bacteria, followed by Enterococcus, Pseudomonas and Klebsiella. UTI with E. coli was significantly at a higher rate in diabetic patients and Exhibits 100% resistance to Ceftriaxone, Nalidixic acid, Cefuroxime and Cefixime. Bacteria offered a high degree of resistance against commonly used antibiotics-Amoxycillin, Ciprofloxacin, Amikacin, Gentamycin, Levofloxacin, Nalidixic acid and Nitrofurantoin ranging from 7% to 93%. Conclusion: E. coli infection is significantly predominant in UTI cases in this study and exhibits a higher rate of resistance to all antibiotics in diabetic patients than that in non-diabetics. None of the antibiotics is 100% sensitive in diabetic patients. Imipenem, meropenem and Piperacillin remain .......