Comparative prevalence of antimicrobial resistance in community-acquired urinary tract infection cases from representative States of northern and southern India.

CONTEXT

Urinary tract infections (UTIs) are amongst the most common infections described in outpatient settings. Increased antimicrobial resistance (AMR) of urinary tract pathogens is a matter of global public health concern. Treatment of UTI depends on both prevalence and antimicrobial resistance (AMR) of causative bacteria at any specific geographical location.

AIM

This study was undertaken to compare the prevalence of uropathogens and their AMR profile in two different geographical parts of India.

MATERIALS AND METHODS

Clean-catch mid-stream urine samples were collected from adult patients, bacterial flora isolated from human urine was evaluated for antimicrobial susceptibility profile using Kirby Bauer's disc diffusion method among patients from Hyderabad (Southern India), Rajasthan and Punjab (Northern India). The data were analysed using Chi-square (χ2) test, confidence interval (CI), odds ratio (OR) analysis and p-value using SPSS 16 software.

RESULTS

Escherichia coli (55.1%) were the most prevalent isolates followed by Enterococcus faecalis (15.8%). Amikacin was the most active antimicrobial agents which showed low resistance rate of 14%. The present study revealed the geographical difference in prevalence of uropathogens with Klebsiella pneumoniae being the second most common uropathogen followed by E. faecalis in the states from northern India while no K. pneumoniae was seen in samples from southern India but E. faecalis was the second most prevalent organism.

CONCLUSION

Therefore, development of regional surveillance programs is highly recommended for implementation of national CA-UTI guidelines in Indian settings.