ANTI-MICROBIAL SPECTRUM FOR BACTERIAL UROPATHOGENS IN ADULT PATIENTS ASSOCIATED WITH URINARY TRACT INFECTIONS AT GOVERNMENT TEACHING HOSPITAL

V. UJJWALA; SHAIK KAREEMULLA; K. BLESSY HEBSIBHA CHELSIYA; B. ZEENTY; A. VENKATA SUBBA REDDY; R. MADHAV REDDY

doi:10.22159/ijcpr.2023v15i5.3063

Authors

V. UJJWALA Department of General Medicine, Rajiv Gandhi Institute of Medical Sciences, Kadapa-516001, Andhra Pradesh, India
SHAIK KAREEMULLA Department of Pharmacy Practice, P. Rami Reddy Memorial College of Pharmacy, Kadapa-516001, Andhra Pradesh, India
K. BLESSY HEBSIBHA CHELSIYA Department of Pharmacy Practice, P. Rami Reddy Memorial College of Pharmacy, Kadapa-516001, Andhra Pradesh, India
B. ZEENTY Department of Pharmacy Practice, P. Rami Reddy Memorial College of Pharmacy, Kadapa-516001, Andhra Pradesh, India
A. VENKATA SUBBA REDDY Department of Pharmacy Practice, P. Rami Reddy Memorial College of Pharmacy, Kadapa-516001, Andhra Pradesh, India
R. MADHAV REDDY Department of Pharmacy Practice, P. Rami Reddy Memorial College of Pharmacy, Kadapa-516001, Andhra Pradesh, India

DOI:

https://doi.org/10.22159/ijcpr.2023v15i5.3063

Keywords:

Urinary tract infection, E. coli, Fever, Ciprofloxacin, Nitrofurantoin

Abstract

Objective: Urinary tract infection (UTI) is one of the most common bacterial infections, affecting 150 million people each year worldwide. UTI’s are a significant cause of morbidity in females, infant boys and older men of all age groups. The most common causative agent for UTI is uropathogenic Escherichia coli. Patients suffering from symptomatic UTI are commonly treated with antibiotics. The present study was undertaken to find the etiology, risk factors, clinical pattern, isolated uropathogens and therapeutic profile of UTI.

Methods: It was a prospective, observational, descriptive, cross-sectional study conducted for a period of 6 mo from April 2022 to September 2022 at RIMS, Kadapa. A total of 35 UTI patients were recruited based on study criteria. The data was collected, analysed, summarised as averages. Graph pad prism software was applied for statistics by using Microsoft excel. Fig. represented through bar graphs, pie charts.

Results: In a total of 35 patients suffering from UTI, we found that 7 were males and 28 were females, based on age groups; 2 patients belong to 21-30 y and 18 patients belong to 31-40 y, 10 patients belong to 41-50 age group, 3 patients belong to 51-60 y. In a total of 82 risk factors 40% were diabetes mellitus, 20% were hypertension, 17% were renal calculi, 5% were cyanosis, 11% were BPH, 6% were ESRD. In a total of 95 clinical symptoms, we observed fever (32.5%) as a major symptom, followed by burning micturition (16.5%). Other signs like abdominal pain, urine urgency, hematuria were also reported. On assessing urine culture, uropathogens Escherichia coli (35%) was isolated in majority UTI cases followed by Staphylococcus aureus (17%), Pseudomonas aeruginosa (14%), Candida species (14%), Enterococcus faecium (11%), Proteus species (8%). Total drugs prescribed were 150. Fluoroquinolones (48 in number, 32%) were the most common prescribed antibiotic drug category, followed by Anti-mycobacterial (32 in number, 21%), Cephalosporins (25 in number, 17%), Penicillins (20 in number, 13%), Macrolides (14 in number, 10%), Combinational therapy (11 in number, 7%).

Conclusion: The UTI prevalence was more in females at GGH–RIMS, Kadapa. E. coli was the most common species isolated in UTI patients. At research site, physicians frequently prescribed medications were Ciprofloxacin (fluoroquinolones) and Nitrofurantoin (anti-mycobacterial) for UTI patients.

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References

Kass EH. Asymptomatic infections of the urinary tract. Trans Assoc Am Physicians. 1956;69:56-64, PMID 13380946.

Stamm WE, Counts GW, Running KR, Fihn S, Turck M, Holmes KK. Diagnosis of coliform infection in acutely dysuric women. N Engl J Med. 1982;307(8):463-8. doi: 10.1056/NEJM198208193070802, PMID 7099208.

Hooton TM, Stamm WE. Diagnosis and treatment of uncomplicated urinary tract infection. Infect Dis Clin North Am. 1997;11(3):551-81. doi: 10.1016/s0891-5520(05)70373-1, PMID 9378923.

Foxman B. Urinary tract infection syndromes: occurrence, recurrence, bacteriology, risk factors, and disease burden. Infect Dis Clin North Am. 2014;28(1):1-13. doi: 10.1016/j.idc.2013.09.003, PMID 24484571.

Harding GK, Ronald AR. The management of urinary infections: what have we learned in the past decade? Int J Antimicrob Agents. 1994;4(2):83-8. doi: 10.1016/0924-8579(94)90038-8, PMID 18611593.

O’Brien VP, Hannan TJ, Nielsen HV, Hultgren SJ. Drug and vaccine development for the treatment and prevention of urinary tract infections. Microbiol Spectr. 2016;4(1):1-62. doi: 10.1128/microbiolspec.UTI-0013-2012, PMID 26999391.

O’Brien VP, Hannan TJ, Schaeffer AJ, Hultgren SJ. Are you experienced? Understanding bladder innate immunity in the context of recurrent urinary tract infection. Curr Opin Infect Dis. 2015;28(1):97-105. doi: 10.1097/QCO.0000000000000130, PMID 25517222.

Gupta K, Hooton TM, Stamm WE. Increasing antimicrobial resistance and the management of uncomplicated community-acquired urinary tract infections. Ann Intern Med. 2001;135(1):41-50. doi: 10.7326/0003-4819-135-1-200107030-00012, PMID 11434731.

Barber AE, Norton JP, Wiles TJ, Mulvey MA. Strengths and limitations of model systems for the study of urinary tract infections and related pathologies. Microbiol Mol Biol Rev. 2016;80(2):351-67. doi: 10.1128/MMBR.00067-15, PMID 26935136.

Hanna Wakim RH, Ghanem ST, El Helou MW, Khafaja SA, Shaker RA, Hassan SA. Epidemiology and characteristics of urinary tract infections in children and adolescents. Front Cell Infect Microbiol. 2015;5:45. doi: 10.3389/fcimb.2015.00045. PMID 26075187.

Health Promotion Board-Singapore. Urinary Tract Infection. Available from: http://www.healthhub.sg/a-z/diseases,conditions/210/urinaryTractInfection. [Last accessed on 01 Feb 2016]

Grabe M, Bartoletti R, Bjerklund Johansen TE, Botto H. European association of urology. Guidelines on urological infections; 2015. Available from: http://uroweb.org/wp-content/uploads/19-urological infections.

Foxman B. Epidemiology of urinary tract infections: incidence, morbidity, and economic costs. Am J Med. 2002;113(113)Suppl 1A:5S-13S. doi: 10.1016/s0002-9343(02)01054-9, PMID 12113866.

Ministry of Health-Singapore. Costs and financing: kidney and amputation; urinary tract infections. [Last accessed on 01 Feb 2016]

Dason S, Dason JT, Kapoor A. Guidelines for the diagnosis and management of recurrent urinary tract infection in women. Can Urol Assoc J. 2011;5(5):316-22. doi: 10.5489/cuaj.11214, PMID 22031610.

Nicolle LE, Bradley S, Colgan R, Rice JC, Schaeffer A, Hooton TM. Infectious Diseases Society of America guidelines for the diagnosis and treatment of asymptomatic bacteriuria in adults. Clin Infect Dis. 2005;40(5):643-54. doi: 10.1086/427507. PMID 15714408.