Bacterial Pathogens in Urinary Tract Infection and Their Antibiotic Susceptibility Pattern

Objective: Studies on prevalence of common bacterial pathogens causing UTIs in North India and their antibiotic susceptibility patterns against particular drugs. Materials and methods: A retrospective study conducted in UTI patients attending Dr Lal Path Labs, NRL, Delhi from March 2019 to December 2020. Clean catch midstream urine specimens collected for urine culture and sensitivity tests. Identification carried out by MALDI-TOF and antimicrobial susceptibility evaluated by VITEK® 2 with respective susceptibility cards (AST 280, 281, P628 Biomerieux, India) as per CLSI M100-S-30. Results and Discussion: In a period of 21 months observation, 65,619/2, 72,000 (24.1%) cases were positive to various clinical analyses of urine. Among them 40,568 (61.8%) were females and 25051(38.2%) were males. Female to male infection was 1.6:1. The age wise study of the culture positive cases indicates that the UTI infection occurs from infants (0 year) to elderly people (>=60 years). The 61.1% of the UTIs attributed by E.coli followed by K. pneumoniae (20.3%), Enterococcus faecalis (7.1%), Pseudomonas aeruginosa (5.4%), Proteus mirabilis (2.8%), Enterobacter cloacae (1.6%) Acinetobacter baumannii (1.1%) and Staphylococcus aureus (0.8%). Drug-sensitivity patterns suggest that the most susceptible antibiotic was Amikacin and Penems. However, penicillin derivatives, commonly prescribed advanced-generation cephalosporins, fluoroquinolones have found the most resistant drug among common uropathogens. Conclusion: Our study highlights the epidemiological trend of common bacterial pathogens causing UTIs and promotes information in order to establish the correct use of antibiotics. This study concluded that Gram-negative and Gram-positive uropathogens showed alarming rates of resistance for penicillin derivatives, advanced-generation cephalosporins, fluoroquinolones, and nitrofurantoin, while Amikacin, Penem group and Tigecycline seems the only suitable antimicrobials that could help clinicians in starting rational empirical antibiotic therapy.