Pattern of Antimicrobial Resistance to Escherichia Coli Among the Urinary Tract Infection Patients in Bangladesh

Abstract

Urinary Tract Infection (UTI) is very common in our day-to-day clinical practice. Among all the organisms Escherichia coli (E coli) is the most common but antimicrobial resistance becomes an alarming issue for UTI management now a days. Aim of this study is to assess the pattern of antimicrobial resistance to E coli among the UTI patients in Jashore, Bangladesh. This observational study was conducted from February, 2017 to January, 2018 in the district of Jashore, Bangladesh. We recruited 696 patients of both sex with UTI only infected by E coli. We had excluded the patients with UTI caused by other than E coli, female during menstruation, pregnancy, history of taking antibiotics within last 21 days, catheterization within 1 month and pelvic organ & genito urinary tract surgery within 6 months. Evaluation of antimicrobial resistance was done according to the standard bacteriological methods. Mean age of our study cases was 41.46±17.21 years with the range from 15 to 91 years. More than 85% participants were female with a sex ratio was 8:1.5. Reproductive age group ranged from 21 to 50 years was affected most commonly which constituted approximately two-third of our study. Our study revealed that the maximum antimicrobial resistance to E coli was Cotrimoxazole (95.0%), followed by Ceftazidime (75.7%), Gentamicin (70.3%), Amikacin (69.0%), Imipenam (58.9 %,), Cefixime (58.0%), Ciprofloxacin (57.3%), Azithromycin (56.0%), Cefuroxime (46.6%), Cefotaxime (37.4%), Ceftriaxone (35.2%), Meropenem (32.2%), Nitrofurantion (4.7%). With the high magnitude of antimicrobial resistance to E coli among the UTI patients even with extended generation of Cephalosporins, Carbapenams, Ciprofloxacin, Cotrimoxazole, Azithromycin and Aminoglycosides, our recommendation as first line empirical treatment option in UTI should be Nitrofurantoin due to low resistance pattern.