Prevalence of multidrug resistant uropathogens isolated from different age groups in South-India: a cross-sectional study
DOI:
https://doi.org/10.18203/2320-6012.ijrms20220984Keywords:
Urinary tract infection, Uropathogens, Antibiotics, Multi-drug resistanceAbstract
Background: Urinary tract infections (UTIs) continue to be one of the most common infections encountered by clinicians. The purpose of this study is to identify relevant multidrug resistance (MDR) patterns in South India.
Methods: 401 urine culture samples with significant bacteriuria were collected from labs in South India between January 2019 and December 2020. Routine biochemical tests were conducted for primary identification of uropathogens. Antibiotic susceptibility testing was performed according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Statistical package for the social sciences (SPSS) 16 and Microsoft excel were used to analyse data and determine MDR patterns.
Results: The results showed that 54% of cultures with significant bacteriuria exhibited an organism with multidrug resistance. Of these, extended-spectrum beta-lactamases (ESBL) resistance was confirmed in 34.9%. Furthermore, over half (54%) of significant cultures were from outpatients. The incidence of UTIs was highest during the summer and at the lowest in the second phase of the monsoon season.
Conclusions: Although the sample collection was limited to a few centres in South India, the results of our study justifies the rationale behind stringent regulation of antibiotic use and careful monitoring of antimicrobial resistance.
References
Stamm WE, Norrby SR. Urinary tract infections: disease panorama and challenges. J Infect Dis. 2001;183(1):S1-4.
Foxman B. Urinary tract infection syndromes: occurrence, recurrence, bacteriology, risk factors, and disease burden. Infect Dis Clin North Am. 2014;28:1-13.
Sugianli AK, Ginting F, Parwati I, de Jong MD, Leth FV, Schultsz C. Antimicrobial resistance among uropathogens in the Asia-Pacific region: a systematic review. JAC-Antimicrobial Resistance. 2021;3(1).
Bader MS, Loeb M, Brooks AA. An update on the management of urinary tract infections in the era of antimicrobial resistance. Postgraduate Medicine. 2017;129(2):242-58.
M02 - Performance Standards for Antimicrobial Disk Susceptibility Tests, 13th Edition. Clinical and Laboratory Standards Institute. 2021.
M100 - Performance Standards for Antimicrobial Susceptibility Testing, 29th Edition. Clinical and Laboratory Standards Institute. 2021.
Magiorakos AP, Srinivasan A, Carey RB, Carmeli Y, Falagas ME, Giske CG, et al. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect. 2012;18:268-81.
Veeraraghavan B, Jesudason MR, Prakash JAJ. Antimicrobial susceptibility profiles of gram-negative bacteria causing infections collected across India during 2014–2016: Study for monitoring antimicrobial resistance trend report. Indian J Med Microbiol. 2018;36:32-6.
Flores-Mireles A, Walker J, Caparon M. Urinary tract infections: epidemiology, mechanisms of infection and treatment options. Nat Rev Microbiol. 2015;13:269-84.
Khoshnood S, Heidary M, Mirnejad R, Bahramian A, Sedighi M, Mirzaei H. Drug-resistant gram-negative uropathogens: A review. Biomed Pharmacother. 2017;94:982-94.
Kothari A, Sagar V. Antibiotic resistance in pathogens causing community-acquired urinary tract infections in India: a multicenter study. J Infect Dev Ctries. 2008;2:354-8.
Ravishankar U, Thayanidhi P. Antimicrobial Resistance Among Uropathogens: Surveillance Report From South India. Cureus. 2021;13(1):e12913.
Gharavi MJ, Zarei J, Roshani-Asl P. Comprehensive study of antimicrobial susceptibility pattern and extended spectrum beta-lactamase (ESBL) prevalence in bacteria isolated from urine samples. Sci Rep. 2021;11:578.
Addis T, Mekonnen Y, Ayenew Z, Fentaw S, Biazin H. Bacterial uropathogens and burden of antimicrobial resistance pattern in urine specimens referred to Ethiopian Public Health Institute. PLoS One. 2021;16(11):e0259602.
Bhonsle K, Vyas H, Hemwani K, Vyas A. Study of prevalence of urinary tract infections in patients of Ujjain, Madhya Pradesh (India). Int J Scientif Res. 2020;9(11).
Bency JAT, Priyanka R, Jose P. A study on the bacteriological profile of urinary tract infection in adults and their antibiotic sensitivity pattern in a tertiary care hospital in central Kerala, India. Int J Res Med Sci. 2017;5:666-9.
Pardeshi P. Prevalence of urinary tract infections and current scenario of antibiotic susceptibility pattern of bacteria causing UTI. Indian J Microbiol Res. 2018;5(3):334-8.
Prakash D, Saxena RS. Distribution and Antimicrobial Susceptibility Pattern of Bacterial Pathogens Causing Urinary Tract Infection in Urban Community of Meerut City, India. International Scholarly Research Notices. 2013;749629.
Akhavizadegan H, Hosamirudsari H, Piroti H, Akbarpour S. Antibiotic resistance: a comparison between inpatient and outpatient uropathogens. East Mediterr Health J. 2021;27(2):124-30.
Gebremariam G, Legese H, Woldu Y. Bacteriological profile, risk factors and antimicrobial susceptibility patterns of symptomatic urinary tract infection among students of Mekelle University, northern Ethiopia. BMC Infect Dis. 2019;19:950.
Chandrasekhar D, Dollychan A, Roy BM, Cholamughath S, Parambil JC. Prevalence and antibiotic utilization pattern of uropathogens causing community-acquired urinary tract infection in Kerala, India. J Basic Clin Physiol Pharmacol. 2018;29(6):671-7.
Simmering JE, Tang F, Cavanaugh JE, Polgreen LA, Polgreen PM. The Increase in Hospitalizations for Urinary Tract Infections and the Associated Costs in the United States, 1998–2011. Open Forum Infect Dis. 2017;4(1).
