scholarly journals High multidrug resistance in urinary tract infections in a tertiary hospital, Kathmandu, Nepal

2021 ◽  
Vol 11 (1) ◽  
pp. 24-31
Author(s):  
S. Shakya ◽  
J. Edwards ◽  
H. A. Gupte ◽  
S. Shrestha ◽  
B. M. Shakya ◽  
...  
Keyword(s):  
Multidrug Resistance ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Tertiary Care ◽  
Tertiary Hospital ◽  
Urine Samples ◽  
University Teaching ◽  
Care Hospital ◽  
High Prevalence ◽  
Tract Infections

SETTING: Tribhuvan University Teaching Tertiary Care Hospital, Kathmandu, Nepal, May–October 2019.OBJECTIVE: 1) To describe the bacteriological profile, 2) to identify the antimicrobial resistance (AMR) pattern, and 3) to find the demographic characteristics associated with the presence of bacterial growth and multidrug resistance (MDR) in adult urine samples undergoing culture and drug susceptibility testing.DESIGN: This was a hospital-based, cross-sectional study using routine laboratory records.RESULTS: Among 11,776 urine samples, 16% (1,865/11,776) were culture-positive, predominantly caused by Escherichia coli (1,159/1,865; 62%). We found a high prevalence of resistance to at least one antibiotic (1,573/1,865; 84%) and MDR (1,000/1,865; 54%). Resistance to commonly used antibiotics for urinary tract infections (UTIs) such as ceftazidime, levofloxacin, cefepime and ampicillin was high. Patients aged 60 years (adjusted prevalence ratio [aPR] 1.6, 95% CI 1.4–1.7) were more likely to have culture positivity. Patients with age 45 years (45–59 years: aPR 1.5, 95% CI 1.3–1.7; 60 years: aPR 1.4, 95% CI 1.2–1.6), male sex (aPR 1.3, 95% CI 1.2–1.5) and from inpatient settings (aPR 1.4, 95% CI 1.2–1.7) had significantly higher prevalence of MDR.CONCLUSION: Urine samples from a tertiary hospital showed high prevalence of E. coli and MDR to routinely used antibiotics, especially among inpatients. Regular surveillance and application of updated antibiograms are crucial to monitor the AMR situation in Nepal.

scholarly journals A study on catheter associated urinary tract infections (CAUTI) and antibiotic sensitivity pattern of uropathogens causing CAUTI from a tertiary care hospital

2021 ◽  
Vol 8 (3) ◽  
pp. 196-199
Author(s):  
Archana Rao K ◽  
Vishwajith ◽  
Ritika Sahkare ◽  
Sangeetha S
Keyword(s):  
Urinary Tract ◽  
Infection Control ◽  
Urinary Tract Infections ◽  
Tertiary Care ◽  
Clinical Signs ◽  
Antibiotic Sensitivity ◽  
Urine Samples ◽  
Care Hospital ◽  
Sensitivity Pattern ◽  
Tract Infections

Catheter-associated urinary tract infections (CAUTI), remains the commonest hospital-acquired infection (HAI). This emphasizes the need to implement and monitor effective infection control programs to reduce the risk of CAUTI. Aim of the present study was to determine the etiology with antibiotic susceptibility and also to calculate CAUTI rate. The Patients admitted in intensive care unit (ICU), Rajarajeshwari Medical College and Hospital who were on urinary catheter insertion for >48 hours from 1 August, 2019 to 30 September, 2019 were included in the study. Under aseptic conditions urine samples were collected from clinically suspected cases of CAUTI, the samples were processed in the department of Microbiology, as per standard protocols. Uropathogens were isolated, identified and subjected to antibiotic sensitivity test. CAUTI rate was calculated and results were noted. Among 460 patients on catheter in ICU, 28(6%) patients developed clinical signs or symptoms of UTI. Of 28 urine samples cultured, 4(14%) yielded growth of single organis [Escherichia coli (3), Klebsiella (1)] and 24(86%) showed no evidence of growth. 2300 catheter days were obtained of 460 patients on indwelling catheter in ICU. Thus CAUTI rate was 1.74 per 1000 catheter days over a 2 month period.CAUTI remained a great burden to patient safety and a challenge to the infection control team. Implementation of proper care bundles and continuous education to health care workers plays a key role in reducing the CAUTI rates, thereby decreasing the morbidity and hospital stay to the patients.

scholarly journals High prevalence of multidrug resistant uropathogens: A recent audit of antimicrobial susceptibility testing from a tertiary care hospital in Bangladesh

2020 ◽  
Vol 36 (6) ◽  
Author(s):  
Chandrika Dasgupta ◽  
Md. Abdur Rafi ◽  
Md. Abdus Salam
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Antimicrobial Susceptibility ◽  
Susceptibility Testing ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Drug Resistant ◽  
High Prevalence ◽  
Tract Infections

Objectives: Urinary tract infections due to multi drug resistant bacteria have been on the rise globally with serious implications for public health. The objective of this study was to explore the prevalence of multi drug resistant uropathogens and to correlate the urinary tract infections with some demographic and clinical characteristics of patients admitted in a tertiary care hospital in Bangladesh. Methods: A cross sectional prospective study was conducted at Shaheed Ziaur Rahman Medical College Hospital, Bogura, Bangladesh among clinically suspected urinary tract infection patients from January to December, 2018. Clean-catch midstream or catheter-catch urine samples were subjected to bacteriological culture using chromogenic agar media. Antimicrobial susceptibility testing of the isolates was done by Kirby-Bauer disk diffusion method following Clinical and Laboratory Standards Institute guidelines. Descriptive statistical methods were used for data analysis. Results: Culture yielded a total of 537 (42.8%) significant bacterial growths including 420 (78.2%) multi drug resistant uropathogens from 1255 urine samples. Escherichia coli was the most common isolate (61.6%) followed by Klebsiella spp. (22.5%), Pseudomonas spp. (7.8%), Staphylococcus aureus (5.4%) and Enterobacter spp. (2.6%) with multi drug resistance frequency of 77.6%, 71.9%, 90.5%, 86.2% and 92.9% respectively. There was female preponderance (M:F; 1:1.97; P=0.007) but insignificant differences between paediatric and adult population (43.65% vs. 42.57%) and also among different age groups. Diabetes, chronic renal failure, fever and supra-pubic pain had significant association as co-morbidities and presentations of urinary tract infections (P<0.05). Multi drug resistance ranged from 3.7 to 88.1% including moderate to high resistance found against commonly used antibiotics like ciprofloxacin, cephalosporin, azithromycin, aztreonam, cotrimoxazole and nalidixic acid (28.6 to 92.9%). Isolates showed 2.4 to 32.2% resistance to nitrofurantoin, amikacin, netilmicin and carbapenems except Pseudomonas spp. (66.7% resistance to nitrofurantoin) and Enterobacter spp. (28.6 to 42.9% resistance to carbapenems). Conclusion: There is very high prevalence of multi drug resistant uropathogens among hospitalized patients and emergence of carbapenem resistance is an alarming situation. Antibiotic stewardship program is highly recommended for hospitals to combat antimicrobial resistance. doi: https://doi.org/10.12669/pjms.36.6.2943 How to cite this:Dasgupta C, Rafi MA, Salam MA. High prevalence of multidrug resistant uropathogens: A recent audit of antimicrobial susceptibility testing from a tertiary care hospital in Bangladesh. Pak J Med Sci. 2020;36(6):---------. doi: https://doi.org/10.12669/pjms.36.6.2943 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Infection surveillance analysis of catheter associated urinary tract infections in obstetrics and gynecology department of a tertiary care hospital of Central India

2017 ◽  
Vol 7 (1) ◽  
pp. 215
Author(s):  
Mudita Jain ◽  
Rituja Kaushal ◽  
Malini Bharadwaj
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Tertiary Care ◽  
Central India ◽  
Integrated Approach ◽  
Obstetrics And Gynecology ◽  
Care Hospital ◽  
Stewardship Program ◽  
Tract Infections ◽  
A Prospective Study

Background: The prevalence of catheter associated urinary tract infections (CAUTIs) in the catheterized patients in acute care settings (catheter used for <7 days) is 3%-7%, in patients who require a urinary catheter for >7 days, it is up to 25% and it approaches 100% after 30 days. As device related hospital acquired infections are imposing major threats in surgical realm of medical sciences, this study was undertaken with the objective to asses catheter related urinary tract infections magnitude.Methods: This study was undertaken in a tertiary care setting of Obstetrics and Gynecology Department of a Central Indian city. It is a prospective study conducted over a full year span from April 2016 to March 2017.Results: CAUTI was calculated as 8.95 per thousand catheter days for the whole study period. Out of the total number of 18 urinary isolates, E. Coli and Enterococcus species were more commonly implicated.Conclusions: In order to restraint the enigma, a multidisciplinary integrated approach including periodic training sessions for all health care workers based on bundled care interventions supervisory checklists etc. is needed. Aseptic techniques along with IDSA (Infectious disease society of America) guidelines/other similar protocols are recommended to bring down overall prevalence. Prudent use of antibiotics is to be accorded as per antibiotic stewardship program to combat drug resistance.

scholarly journals Prevalence and Antibiogram of Bacterial Uropathogens of Urinary Tract Infections from a Tertiary Care Hospital of Bangladesh

2017 ◽  
Vol 9 (3) ◽  
pp. 317-328 ◽  
Author(s):  
S. A. Sanjee ◽  
M. E. Karim ◽  
T. Akter ◽  
M. A. K. Parvez ◽  
M. Hossain ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Tertiary Care ◽  
Age Groups ◽  
Diffusion Method ◽  
Multi Drug Resistance ◽  
Care Hospital ◽  
Resistance Patterns ◽  
Tract Infections ◽  
Antibiotic Resistance Patterns

Urinary tract infections (UTIs) are one of the most frequently occurring infections majority of which are caused by multi-drug resistant (MDR) uropathogens. Hence, the present study was designed to find out the prevalence of bacterial pathogens causing UTIs and to determine their antibiotic resistance patterns against different classes of antibiotics. Clean-catch midstream urine samples were collected from 200 UTI patients of different sex and age groups. The uropathogens were isolated using Hi-Chrome UTI agar, Blood agar, MacConkey agar and then subjected to antibiotic susceptibility analysis against nine antibiotics of different classes using Kirby-Bauer’s disc diffusion method. From 55.08% positive samples, it was found that females were more prone to UTIs than males and in both cases; the prevalence rate was higher in the age group 21-40 years (33%). Among the uropathogens, E.coli was the predominant etiological agent (57.38%) followed by Enterococcus sp. (36.06%), Pseudomonas aeruginosa (3.28%) and Staphylococcus aureus (3.28%). The pathogens showed remarkable amount of sensitivity against Gentamicin and Ciprofloxacin. The present experiment can be helpful for the clinicians in finding proper drugs in the developing countries like Bangladesh where multi-drug resistance problem has just complicated the treatment of UTIs.

scholarly journals Antimicrobial Resistance among Pregnant Women with Urinary Tract Infections Attending Antenatal Clinic at Levy Mwanawasa University Teaching Hospital (LMUTH), Lusaka, Zambia

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Kekelwa Inyambo Yeta ◽  
Charles Michelo ◽  
Choolwe Jacobs
Keyword(s):  
Urinary Tract ◽  
Antimicrobial Resistance ◽  
Pregnant Women ◽  
Urinary Tract Infections ◽  
Antenatal Clinic ◽  
University Teaching ◽  
Categorical Variables ◽  
Surveillance Systems ◽  
High Prevalence ◽  
Tract Infections

Introduction. Globally, there is a growing concern over antimicrobial resistance (AMR) which is currently estimated to account for more than 700,000 deaths per year worldwide. AMR undermines the management of infectious diseases in general especially in pregnancy where significant bacteriuria continues to be a serious cause of maternal and perinatal morbidity and mortality. We therefore aimed to determine the prevalence of AMR and the associated factors among pregnant women with urinary tract infections (UTIs) attending antenatal clinic at a selected hospital in Lusaka, Zambia. Methods. This was a hospital-based, cross-sectional study conducted between November 2018 and May 2019. Interviewer-administered questionnaire was used to assess the sociodemographic characteristics and behavioural characteristics. Laboratory tests were also conducted. Descriptive statistics of study participants were used to describe the characteristics of the respondents. Chi-square was used to assess the association between categorical variables. The logistic regression analysis was carried out to generate the adjusted odds ratio with 95% confidence interval. Results. Overall (n = 203), the prevalence of UTI was 60% (95% CI: 53.3%–66.7%). The most isolated bacteria were E. coli (59%) and Klebsiella (21%). The prevalence of AMR was found to be 53% (95% CI: 46.1%–59.8%). The drugs highly resistant to antimicrobials were nalidixic acid (88.3%), ampicillin (77.8%), and norfloxacin (58.5%), while the least resistant drug was chloramphenicol (20%). There were no important significant predictors to AMR among pregnant women observed in this study. Conclusion. We found high burden of AMR closely linked to observe high prevalence of UTI suggested in this small population. This suggests a need to develop integrated surveillance systems that aim for early and regular screening of pregnant women for UTI as well as concurrent determination of antibiotic susceptibility patterns. This is important to prevent complications that may endanger maternal and fetal health outcomes. Furthermore, further research is needed to explore reasons for this high prevalence of AMR including examining possible attribution to the misuse of drugs so as to inform, enforce, or adjust the prescription-only policies and enforce antimicrobial stewardship programs.

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