Wed, Apr 9, 2025
Volume 18, Issue 2 (Mar-Apr 2024)
mljgoums 2024, 18(2): 5-7 |
Back to browse issues page
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Rahangdale H, Olambe T, Klabhor P, Bhalavi S, Wanjare V, Shrikhande S. New insight into antibiotic resistance in urinary tract infections: Interplay between community and hospital acquired UTI. mljgoums 2024; 18 (2) :5-7
URL: http://mlj.goums.ac.ir/article-1-1622-en.html
URL: http://mlj.goums.ac.ir/article-1-1622-en.html
Hina Rahangdale1 
, Tejaswini Olambe1 
, Priyanka Klabhor1 , Sangita Bhalavi2 , Varsha Wanjare1 , Sunanda Shrikhande1
, Tejaswini Olambe1 , Priyanka Klabhor1 , Sangita Bhalavi2 , Varsha Wanjare1 , Sunanda Shrikhande1
1- Government Medical College and Hospital, Nagpur, India
2- Government Medical College and Hospital, Nagpur, India ,skhedikar09@gmail.com
2- Government Medical College and Hospital, Nagpur, India ,
Abstract: (1738 Views)
Background: Urinary tract infections (UTIs) are among the most common types of infections affecting people in community and hospital settings. Bacteria are the leading cause of UTIs, followed by fungi. 39% of all healthcare-associated infections (HAIs) affecting all age groups are UTIs, causing high morbidity and mortality rates. The antibiotic susceptibility pattern of causative organisms is changing due to improper antibiotic use. The study was conducted to determine the microbiological profile of both community and HAIs and their antimicrobial susceptibility pattern.
Methods: Clean-catch, mid-stream urine samples collected in the universal wide-mouthed sterile containers were transported to the laboratory. Samples were processed by standard conventional microbiological procedures. Antimicrobial susceptibility was done using the Kirby-Bauer disc diffusion method on Mueller-Hinton agar plates.
Results: The most common causative organisms among gram-negative bacteria were E coli (26.05%), followed by Klebsiella spp (20.37%), and Enterococcus spp (12.81%) was more common among the gram-positive bacteria. Non-albicans Candida (64.10%) were more commonly isolated than Candida albicans (35.90%). E coli was highly susceptible to nitrofurantoin and fosfomycin, and Klebsiella spp and Enterococcus spp were similarly highly susceptible. Antibiotic resistance was more common among bacteria isolated in HAIs.
Conclusion: In both settings, E coli was the most common causative organism. The incidence of non-albicans Candida species has increased in comparison to Candida albicans. Antimicrobial susceptibility to empirical 3rd-generation cephalosporins and fluoroquinolones has drastically decreased. Hospital-acquired UTIs are a rising threat to the healthcare system and community. Based on hospitals’ antimicrobial policy formulated by studying antimicrobial susceptibility patterns, empirical treatment should be chosen.
Methods: Clean-catch, mid-stream urine samples collected in the universal wide-mouthed sterile containers were transported to the laboratory. Samples were processed by standard conventional microbiological procedures. Antimicrobial susceptibility was done using the Kirby-Bauer disc diffusion method on Mueller-Hinton agar plates.
Results: The most common causative organisms among gram-negative bacteria were E coli (26.05%), followed by Klebsiella spp (20.37%), and Enterococcus spp (12.81%) was more common among the gram-positive bacteria. Non-albicans Candida (64.10%) were more commonly isolated than Candida albicans (35.90%). E coli was highly susceptible to nitrofurantoin and fosfomycin, and Klebsiella spp and Enterococcus spp were similarly highly susceptible. Antibiotic resistance was more common among bacteria isolated in HAIs.
Conclusion: In both settings, E coli was the most common causative organism. The incidence of non-albicans Candida species has increased in comparison to Candida albicans. Antimicrobial susceptibility to empirical 3rd-generation cephalosporins and fluoroquinolones has drastically decreased. Hospital-acquired UTIs are a rising threat to the healthcare system and community. Based on hospitals’ antimicrobial policy formulated by studying antimicrobial susceptibility patterns, empirical treatment should be chosen.
Keywords: Community-acquired infections, Cross infection, Drug Resistance, Microbial, Urinary Tract Infections
Research Article: Original Paper |
Subject:
Microbiology
Received: 2023/02/9 | Accepted: 2024/01/24 | Published: 2024/04/28 | ePublished: 2024/04/28
Received: 2023/02/9 | Accepted: 2024/01/24 | Published: 2024/04/28 | ePublished: 2024/04/28
References
1. Procop GW, Church DL, et al. Koneman's Color Atlas and Textbook of Diagnostic Microbiology 7th ed. Philadelphia: Wolters Kluwer;2017.2, Introduction to microbiology;80-83. [View at Publisher]
2. Al-Rubeaan KA, Moharram O, Al-Naqeb D, Hassan A, Rafiullah MR. Prevalence of urinary tract infection and risk factors among Saudi patients with diabetes. World J Urol. 2013; 31(3): 573-8. [View at Publisher] [DOI] [PMID] [Google Scholar]
3. Chaturvedi A, Garg R, Singh VA. Comparative evaluation of different culture media for the isolation and identification of common urinary pathogens. International Journal of Research in Medical Sciences. 2017; 5(8): 3676–3679. [View at Publisher] [DOI]
4. Adugna B, Sharew B, Jemal M. Bacterial Profile, Antimicrobial Susceptibility Pattern, and Associated Factors of Community- and Hospital-Acquired Urinary Tract Infection at Dessie Referral Hospital, Dessie, Northeast Ethiopia. Int J Microbiol. 2021; 2021: 5553356. [View at Publisher] [DOI] [PMID] [Google Scholar]
5. Kundu D, Paul T, Medhi PS, Bedi N. Hospital Acquired Urinary Tract Infection: An Epidemiological Study Carried out in a Tertiary Care Hospital of North East India. Int. J. Life. Sci. Res.2017;3(3):1059-62. [DOI] [Google Scholar]
6. Khandelwal P, Abraham SN, Apodaca G. Cell biology and physiology of the uroepithelium. Am J Physiol Renal Physiol. 2009; 297(6): F1477-501. [View at Publisher] [DOI] [PMID] [Google Scholar]
7. Dommergues M, Dalkha-Dahmane F, Muller F, Aubry M C, et al. Kidney and urinary tract disorders. Fetal Medicine E-Book: Basic Science and Clinical Practice2008;459. [View at Publisher] [Google Scholar]
8. Hooton TM, Bradley SF, Cardenas DD, Colgan R, Geerlings SE, Rice JC, et al. Diagnosis, prevention, and treatment of catheter-associated urinary tract infection in adults: International Clinical Practice Guidelines from the Infectious Diseases Society of America. Clin infect dis. 2010;50(5):625-63. [View at Publisher] [DOI] [PMID] [Google Scholar]
9. Gupta K, Hooton TM, Stamm WE. Increasing antimicrobial resistance and the management of uncomplicated community-acquired urinary tract infections. Ann int med. 2001;135(1):41-50. [View at Publisher] [DOI] [PMID] [Google Scholar]
10. CDC-health care associated infections-type of infections. [View at Publisher]
11. Fagan M, Lindbæk M, Grude N, Reiso H, Romøren M, Skaare D, et al. Antibiotic resistance patterns of bacteria causing urinary tract infections in the elderly living in nursing homes versus the elderly living at home: an observational study. BMC geriatrics. 2015;15(1):1-7. [View at Publisher] [DOI] [PMID] [Google Scholar]
12. Kamat US, Fereirra A, Amonkar D, Motghare DD, Kulkarni MS. Epidemiology of hospital acquired urinary tract infections in a medical college hospital in Goa. Indian J Urol. 2009; 25(1): 76-80. [View at Publisher] [DOI] [PMID] [Google Scholar]
13. Saha S, Nayak S, Bhattacharyya I, Saha S, Mandal AK, Chakraborty S, et al. Understanding the patterns of antibiotic susceptibility of bacteria causing urinary tract infection in West Bengal, India. Front Microbiol. 2014; 5: 463. [View at Publisher] [DOI] [PMID] [Google Scholar]
14. Aypak C, Altunsoy A, Düzgün N. Empiric antibiotic therapy in acute uncomplicated urinary tract infections and fluoroquinolone resistance:A prospective observational study. Ann Clin Microbiol Antimicrob. 2009; 8: 27 [View at Publisher] [DOI] [PMID] [Google Scholar]
15. Collee JG, Mackie TJ, McCartney JE. Mackie & McCartney Practical Medical Microbiology. 14th ed. Churchill Livington, New York; 1996: 53-94 [View at Publisher]
16. Weinstein MP. Performance standards for antimicrobial susceptibility testing; thirty-second informational supplement. 30 ed. Clinical and Laboratory standards Institute. 2020. [View at Publisher]
17. Arjunan M, Al Salamah AA, Amuthan M. Prevalence and antibiotic susceptibility of uropathogens in patients from a rural environment, Tamil Nadu. Am J Infect Dis 2010;6: 29. [View at Publisher] [DOI]
18. Chooramani G, Jain B, Chauhan PS. Prevalence and antimicrobial sensitivity pattern of bacteria causing urinary tract infection; study of a tertiary care hospital in North India. Clinical Epidemiology and Global Health. 2020; 8: 890-893. [View at Publisher] [DOI] [Google Scholar]
19. Sood S, Gupta R. Antibiotic resistance pattern of community acquired uropathogens at a tertiary care hospital in jaipur, rajasthan. Indian J Community Med 2012; 37:39-44. [View at Publisher] [DOI] [PMID] [Google Scholar]
20. Rafeeq A, Koul AN. Community and Hospital acquired Urinary Tract Infections- Two Faces Of A Coin. IJAR. 2020;10(10):1-3. [View at Publisher] [DOI]
21. Mancini A, Pucciarelli S, Lombardi FE, Barocci S, Pauri P, Lodolini S. Differences between Community - and Hospital - acquired urinary tract infections in a tertiary care hospital. New Microbiol. 2020; 43(1): 17-21. [View at Publisher] [PMID] [Google Scholar]
22. Singhal A, Sharma R, Jain M, Vyas L. Hospital and Community Isolates of Uropathogens and their Antibiotic Sensitivity Pattern from a Tertiary Care Hospital in North West India. Ann Med Health Sci Res.2014; 4(1): 51-56. [View at Publisher] [DOI] [PMID] [Google Scholar]
23. Dias V. Candida species in the urinary tract: is it a fungal infection or not? Future Microbiol. 2020;15(2): 81-83 [View at Publisher] [DOI] [PMID] [Google Scholar]
24. Krcmery S, Dubrava M, Krcmery Jr V. Fungal urinary tract infections in patients at risk. International journal of antimicrobial agents. 1999; 11(3-4): 289-91. [View at Publisher] [DOI] [PMID] [Google Scholar]
25. Goyal RK, Sami H, Mishra V, Bareja R, Behara RN. Non-albicans candiduria: an emerging threat. Journal of Applied Pharmaceutical Science. 2016; 6(3): 048-50. [View at Publisher] [DOI] [Google Scholar]
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
Enamad
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.