Drug Resistance Pattern of the Isolated Organisms While Treating UTIs

Background: Urinary tract infections (UTI), which are caused by the presence and growth of microorganisms in the urinary tract, are perhaps the single commonest bacterial infections of mankind. Urinary tract infection is a most common infectious disease after respiratory tract infection in community practice. Aim of the study: The aim of this study is to assess the drug resistance pattern of the isolated organism while treating UTIs. Material & Methods: This was a prospective study carried out in the Molecular Biology Laboratory, Institute of Biological Sciences, University of Rajshahi, Bangladesh during the period of July 2008 to June 2011. In the planning phase, we estimated a total sample size of 750 cases. The study population comprised of four hundred fifty (450) female patients clinically suspected of having UTI aged between 15-45 years attending the OPDs or admitted to Rajshahi Medical College Hospital, Rajshahi, SZMCH, Bogra, Combined Military Hospital (CMH), Bogra, Bangladesh, Rangpur Medical College, Rangpur, Dinajpur Medical College, Dinajpur in the Northern regions of Bangladesh. Selection of the participants of the study population was done on the basis of some inclusion and exclusion criteria. Results: The prevalence rate of urinary tract infection (UTI) of the present study population was therefore 33.55%. Among the 151 confirm diagnosed UTI patients, asymptomatic UTI (Group A) was diagnosed in 54 women whereas, significant bacteriuria i.e. symptomatic UTI (Group B) was found in 97 patients. The prevalence of symptomatic UTI was therefore higher than asymptomatic UTI. The highest UTI patients 68 (44.44%) were women within the 26-35 years age group followed by Group-C 46 (31.08%) whose ages are within 36-45 years, while the Group-A women (15-25 years of age) were the least sufferers of UTI (24.83%). The antibiotic susceptibility pattern of isolated uropathogens (both Gram-negative and Gram-positive bacteria) from the urine samples of the study population has been shown. The results showed that in general most of the urinary isolates showed higher resistance to commonly used and comparatively old drugs namely- Nalidixic acid, Cotrimoxazole, Nitrofurantoin, Ceftazidime, Ceftriaxone and Azithromycin. Cephradine showed moderate resistance (55%). On the other hand, Staphylococcus saprophyticus was found to be highly sensitive to Imipenem (80%), followed by gentamicin (71.4%), Azithromycin (65.7%), Amikacin (64.3%). Ceftriaxone and Nirofurantoin both showed moderate sensitivity of 60%. Staphylococcus aureus showed highest resistance to Ceftazidine (78%), followed by Ciprofloxacin (77.5%), Cotrimoxazole and Nalidixic acid (75%), Ceftriaxone (66.7%). Conclusion: The major pathogen E. Coli causing UTI in the Northern regions of Bangladesh and other gram negative (as well as gram positive) isolates were more highly sensitive to Imipenem, Amikacin and Gentamicin as compared to the other antibiotics tested.