Prevalence and antibiotic utilization pattern of uropathogens causing community-acquired urinary tract infection in Kerala, India
-
Dilip Chandrasekhar
,
Athira Dollychan
Abstract
Background:
A prospective observational study was carried out over a period of 6 months among the inpatients and outpatients in the departments of general medicine, urology, obstetrics, and gynecology of a tertiary level referral hospital in south Malabar region of Kerala to assess the prevalence of various bacterial isolates and their changing susceptibility to antimicrobial agents and to evaluate the pattern of antibiotic utilization in urinary tract infection (UTI).
Methods:
A total of 680 samples were analyzed from December 2015 to May 2016; among them, only 74 patients met the inclusion criteria. Of the 74 patients, 53 were female and 21 were male. Female patients were found to be significantly higher in number in the age group of 61–70years. The maximum number of UTI cases was reported from the general medicine department.
Results:
The disease was more significantly portrayed in suburbans (47%) and rural (38%) population compared with urbans (15%). Fever (60.81%) and dysuria (48.64%) were the most common symptoms. Diabetes (34%) was found to be the major predisposing factor followed by postmenopausal factors (24%), previous UTI (14%), renal disease (9%), benign prostatic hypertrophy (8%), smoking (7%), and oral contraceptives (4%). Escherichia coli was the major isolate (n=36) followed by Klebsiella (n=13), Citrobacter (n=8), Enterococcus (n=7), Enterobacter (n=4), Pseudomonas (n=3), coagulase-negative Staphylococcus (n=2), and Proteus (n=1). Majority of patients were prescribed with cefoperazone+sulbactum (n=28) followed by levofloxacin (n=25) and nitrofurantoin (n=10). Cumulative antibiogram was prepared as the final step of the study using the WHONET 5.6 software. Gram-negative organisms such as E. coli, Klebsiella, and Citrobacter showed higher susceptibility toward piperacillin-tazobactum, cefoperazone-sulbactam, imipenem, meropenem, amikacin, and netilmicin. Gram-positive organisms such as Enterococcus showed higher susceptibility toward piperacillin-tazobactum, cefoperazone-sulbactam, amoxicillin-clavulanic acid, vancomycin, and linezolid.
Conclusions:
In our setting, routine culture may be necessary as treatment failure with empirical therapy is likely to occur.
Acknowledgments
Authors are grateful to Dr. Jaffer C. P., MBBS, MD, MRCP, FRCP (Consultant Physician) General Medicine, Dr. Murali P. M., MBBS, MS, Mch (Urology) Consultant Urologist, and Dr. Nayanthara, MBBS, DGO, MD (Consultant Gynecologist), for their cooperation, support, and guidance.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
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Articles in the same Issue
- Frontmatter
- Review
- Pharmacotherapy of ulcerative colitis – current status and emerging trends
- Reproduction
- Bisphenol A decreases the spontaneous contractions of rat uterus in vitro through a nitrergic mechanism
- Cardiovascular Function
- An aqueous extract of the Anogeissus leiocarpus bark (AEAL) induces the endothelium-dependent relaxation of porcine coronary artery rings involving predominantly nitric oxide
- Oxidative Stress
- Alleviation of carbon tetrachloride-induced hepatocellular damage and oxidative stress with a leaf extract of Glyphae brevis (Tiliaceae)
- Protective effect of chloroform extract of Stereospermum chelonoides bark against amyloid beta42 induced cell death in SH-SY5Y cells and against inflammation in Swiss albino mice
- Metabolism
- Iodine in excess in the alterations of carbohydrate and lipid metabolic pattern as well as histomorphometric changes in associated organs
- Immune Response
- Screening of the immunomodulatory and antibacterial activity of Termitomyces letestui (Pat.) Heim (Lyophyllaceae), an edible mushroom from Cameroon
- Inflammation
- High-fat diet modifies cytokine gene expression and exacerbates the effects of acute pancreatitis in the liver of rats
- The acute anti-inflammatory action of xylopic acid isolated from Xylopia aethiopica
- Infection
- Prevalence and antibiotic utilization pattern of uropathogens causing community-acquired urinary tract infection in Kerala, India
- Phytotherapy
- Assessment of azadirachtin-A, a neem tetranortritarpinoid, on rat spermatozoa during in vitro capacitation
- Phenolic-rich extracts of Eurycoma longifolia and Cylicodiscus gabunensis inhibit enzymes responsible for the development of erectile dysfunction and are antioxidants
- Evaluation of anti-obesity and lipid-lowering properties of Vaccinium myrtillus leaves powder extract in a hamster model
