Assessment of Microbial Diversity Pattern of Sensitivity and Antimicrobial Susceptibility in Patients Admitted with Urosepsis

Abstract

Objectives: To determine the spectrum of bacteria causing urosepsis and antibiotic sensitivity patterns among admitted patients with a clear diagnosis of urosepsis. Methodology: A cross-sectional study was conducted in General Medicine OPDs at the Hayatabad Medical Complex, Peshawar from January 2022 to December 2022. Data was collected prospectively. We included a total of 800 patients with a confirmed diagnosis of urosepsis, the diagnosis was confirmed using >5 pus cells per HPF as a cut-off value. Samples were sent for culture sensitivity testing in the microbiology lab and after identification of the causative bacteria, the sensitivities to a spectrum of antibiotics were assessed. Results: Out of the 800 enrolled patients, samples of 664 patients grew colonies, mostly comprised of Gram-negative ones. The gender distribution showed (54.70%) females as compared to (45.30%) males, with an age range of 18 -70 years. The species grown primarily is E. Coli 57.5%, Providencia Sp. 9.3%, Enterococcus faecium 7.5%, Enterobacter 7.5%, Klebsiella 2.4%, and a mixed growth pattern in 9.0% of samples. The sensitivity percentage for E. coli against Meropenem was 99.5%, Imipenem 99.6%, Colistin 99.9%, Polymyxin-B 99.9%, Fosfomycin 96.4%, Amikacin 96.7%, Gentamicin 97.4%, Nitrofurantoin 91.5%, Ceftriaxone 34.4%, Ciprofloxacin 31.5%, Piperacillin/Tazobactam 10.2%, Cefepime 39.1%, Co-Amoxiclav 19.0%, Ceftazidime 37.4% and Cefoperazone /Sulbactam 26.5%.  Conclusion: The spectrum of bacteria sensitivity showed high sensitivity towards Meropenem, Imipenem, Colistin, Polymyxin-B, Amikacin, and Gentamicin; medium sensitivity to Fosfomycin and Nitrofurantoin; and low sensitivity against Ceftriaxone, Ciprofloxacin, Piperacillin/Tazobactam, Cefepime, Co-Amoxiclav, Ceftazidime, and Cefoperazone /Sulbactam among patients with urosepsis.