Sensitivity and resistance pattern of uropathogens causing urinary tract infections among adults at a teaching hospital in South India - A retrospective analysis.

Abstract

Urinary tract infections (UTIs) are highly prevalent and can lead to severe complications if untreated. While prompt empirical therapy is crucial, initiating treatment without antibiotic susceptibility testing can exacerbate antimicrobial resistance. This study aims to identify the antibiotic sensitivity and resistance pattern of uropathogens causing urinary tract infections in adults at a teaching hospital in South India over five years (2019-2023). This retrospective cross-sectional study analyzed all urine culture reports that were positive for a single species of organisms with a significant colony count from both hospitalized and non-hospitalized patients (aged ≥ 18 yrs) who visited our hospital from January 2019 to December 2023. Data were extracted from the culture reports that were maintained electronically in the Department of Microbiology. Of the total of 46,453 urine culture sensitivity reports available during the study period, 13,124 were culture positive. The majority of the positive urine culture reports belonged to females (62.4%) and the predominant age group affected was >60 years (37.2%). The commonest organisms encountered during these study periods were <i>E. coli</i> (44.6% to 50.5%) followed by <i>Enterococcus</i> (7.8% to 12.4%)/ <i>Klebsiella</i> (9% to 10.5%). Uropathogens exhibited >80% resistance to antibiotics such as ampicillin, cefazolin, ciprofloxacin, penicillin, ceftazidime/clavulanic acid, and cefotaxime in at least one of the study years. Our study shows a concerning trend of increasing resistance among uropathogens to commonly used antibiotics, warranting an urgent need for urine culture-based antibiotic prescribing practices.