Bacterial association in urinary tract infection and their drug resistance among patients in Rajshahi, Bangladesh

Authors

  • Noor E. Farjana Department of Microbiology, Stamford University Bangladesh, Dhaka, Bangladesh
  • Md A. Islam Department of Microbiology, Stamford University Bangladesh, Dhaka, Bangladesh Jazeera Diagnostic Center, Kajihata, Lakhmipur, Rajshahi,
  • Tamanna Zerin Department of Microbiology, Stamford University Bangladesh, Dhaka, Bangladesh http://orcid.org/0000-0002-8582-7167
  • Mosammat A. Begum Department of Microbiology, Stamford University Bangladesh, Dhaka, Bangladesh

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20211730

Keywords:

Urinary tract infection, Antibiotics, Susceptibility, Kirby-Bauer disk diffusion, Bangladesh

Abstract

Background: Urinary tract infection (UTI) is a very common infection worldwide and drug resistance makes the treatment more difficult which may lead to complications along with extended hospital stay. Therefore, this study was designed to find out the prevalence of UTI, and antimicrobial susceptibility pattern of isolates collected from patients of UTI.

Methods: This study was conducted among 1,760 suspected UTI patients from January 2019 to November 2020. Urine samples from mid-stream were transferred to microbiology laboratory following microbiological standard protocol. Microbial identification was performed by microscopy, colony morphology, and biochemical characteristics. Antibiogram was pursued following the standard Kirby-Bauer disk diffusion method.

Results: Our study showed almost 30% of samples were positive and E. coli was found as the highest predominating organism (50.09%) followed by Klebsiella spp., Pseudomonas spp., Enterococcus spp., and Citrobacter spp. The percentage of infection in females was 65.28% which is higher than males. The highest prevalence of UTI has been observed in females aged 21-30 years and males aged 31-40 years. However, E. coli and Pseudomonas spp. showed the highest resistance against Amoxiclav whereas, Klebsiella spp. showed it against co-trimoxazole. Citrobacter spp. showed 100% resistance towards Amikacin, cefixime, nalidixic acid, co-trimoxazole, amoxiclav, ceftazidime, and Enterococcus spp. showed against nalidixic acid and amoxiclav. Moreover, 95.8% isolates collected were resistant towards 3 or more than 3 antibiotics which is very alarming.

Conclusions: Changing trend in antibiotic sensitivity profile of the isolates needs to be monitored as there is limited availability of newer drugs.

References

Odoki M, Aliero AA, Tibyangye J, Maniga JN, Wampande E, Kato CD, et al. Prevalence of bacterial urinary tract infection and associated factors among patients attending hospitals in Bushenyi district, Uganda. Int J Microbiol. 2019;2019:8.

Foxman B. Epidemiology of urinary tract infections: incidence, morbidity, and economic costs. Dis Mon. 2003;49(2):53-70.

Petersen I, Hayward AC. Antibacterial prescribing in primary care. J Antimicrob Chemother. 2007;60(1):43-7.

Parveen R, Rahim I. Study of Bacterial Pathogens in Urinary Tract Infection and their Antimicrobial Sensitivity Pattern. Bangladesh J Infect Dis. 2017;4(2):40-4.

Conway PH, Cnaan A, Zaoutis T, Henry BV, Grundmeier RW, Keren R. Recurrent urinary tract infections in children: risk factors and association with prophylactic antimicrobials. JAMA. 2007;298(2):179-86.

Dias CS, Silva JM, Diniz JS, Lima EM, Marciano RC, Lana LG, et al. Risk factors for recurrent urinary tract infections in a cohort of patients with primary vesicoureteral reflux. Pediatr Infect Dis J. 2010;29(2):139-44.

Banu A, Jyothi R. Asymptomatic bacteriuria in HIV positive individuals in a tertiary care hospital. J HIV Hum Reprod. 2013;1(2):54.

Iduoriyekemwen NJ, Sadoh WE, Sadoh AE. Asymptomatic bacteriuria in HIV positive Nigerian children. J Med Biomed Res. 2012;11(1):88-94.

Ibadin M, Onunu A, Ukoh G. Urinary tract infection in adolescent/young adult Nigerians with acquired human immuno deficiency disease in Benin city. J Biomed Sci. 2006;5(2):55-60.

Mladenović J, Veljović M, Udovicić I, Lazić S, Segrt Z, Ristić P, et al. Catheter-associated urinary tract infection in a surgical intensive care unit. Vojnosanit Pregl. 2015;72(10):883-888.

Yuyun MF, Angwafo III FF, Koulla-Shiro S, Zoung-Kanyi J. Urinary tract infections and genitourinary abnormalities in Cameroonian men. Trop Med Int Health. 2004;9(4):520-5.

Nicolle LE. Uncomplicated urinary tract infection in adults including uncomplicated pyelonephritis. Urol Clin North Am. 2008;35(1):1-12.

Nelson JM, Good E. Urinary tract infections and asymptomatic bacteriuria in older adults. Nurse Pract. 2015;40(8):43-8.

Tandogdu Z, Wagenlehner FM. Global epidemiology of urinary tract infections. Curr Opin Infect Dis. 2016;29(1):73-9.

Ronald A. The etiology of urinary tract infection: traditional and emerging pathogens. Dis Mon. 2003;49(2):71-82.

Aswani SM, Chandrashekar U, Shivashankara K, Pruthvi B. Clinical profile of urinary tract infections in diabetics and non-diabetics. Australas Med J. 2014;7(1):29-34.

Rizvi M, Khan F, Shukla I, Malik A, Shaheen. Rising prevalence of antimicrobial resistance in urinary tract infections during pregnancy: necessity for exploring newer treatment options. J Lab Physicians. 2011;3(2):98-103.

Moue A, Aktaruzzaman SA, Ferdous N, Karim MR, Khalil MM, Das A. Prevalence of urinary tract infection in both outpatient department and in patient department at a medical college setting of Bangladesh. Int J Biosci. 2015;7(5):146-52.

Collee JG, Fraser AG, Marmion BP, Simmons A. Tests for identification of Bacteria. In: Mackie and McCartney Practical Medical Microbiology. 14th ed. London: Churchill Livingstone. 1996;131-49.

Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing. Twenty-Sixth Informational Supplement. CLSI document M100-S26. Wayne (PA): CLSI. 2016;50-6.

Flores-Mireles AL, Walker JN, Caparon M, Hultgren SJ. Urinary tract infections: epidemiology, mechanisms of infection and treatment options. Nat Rev Microbiol. 2015;13(5):269-84.

Rosana Y, Billy M, Ocviyanti D. In vitro resistance pattern of urinary tract infections-causing bacteria to ampicillin and ciprofloxacin. Obstet Gynecol Int J. 2019;10(5):372-6.

Katouli M. Population structure of gut Escherichia coli and its role in development of extra-intestinal infections. Iran J Microbiol. 2010;2(2):59-72.

Kayima JK, Otieno LS, Twahir A, Njenga E. Asymptomatic bacteriuria among diabetics attending Kenyatta National Hospital. East Afr Med J. 1996;73(8):524-6.

Moges AF, Genetu A, Mengistu G. Antibiotic sensitivities of common bacterial pathogens in urinary tract infections at Gondar Hospital, Ethiopia. East Afr Med J. 2002;79(3):140-2.

Wanyama J. Prevalence, bacteriology and microbial sensitivity patterns among pregnant women with clinically diagnosed urinary tract infections in Mulago Hospital Labour Ward. Makerere University, Kampala, Uganda, 2003, M.Ed. dissertation of Wanyama. 2003.

Mayanja R. The Prevalence of Asymptomatic Bacteriuria and Associated Factors among Women Attending Antenatal Clinics in Lower Mulago Hospital, Uganda. ASRJETS. 2016;25(1):131-48.

Majumder MM, Ahmed T, Ahmed S, Khan A, Saha C. Antibiotic Resistance in Urinary Tract Infection in a Tertiary Care Hospital in Bangladesh-A Follow-up Study. Med Today. 2019;31(1),9-14.

Sewify M, Nair S, Warsame S, Murad M, Alhubail A, Behbehani K, et al. Prevalence of Urinary Tract Infection and Antimicrobial Susceptibility among Diabetic Patients with Controlled and Uncontrolled Glycemia in Kuwait. J Diabetes Res. 2016;7.

Al Benwan K, Al Sweih N, Rotimi VO. Etiology and antibiotic susceptibility patterns of community- and hospital-acquired urinary tract infections in a general hospital in Kuwait. Med Princ Pract. 2010;19(6):440-6.

Ebie M, Kandakai-Olukemi YT, Ayanbadejo J, Tanyigna KB. Urinary tract infection in a Nigeria Military Hospital. Nig J Microbiol. 2001;15(1):31-7.

Kumar MS, Lakshmi V, Rajagopalan R. Related Articles, Occurrence of extended spectrum beta-lactamases among Enterobacteriaceae spp. isolated at a tertiary care institute. Indian J Med Microbiol. 2006;24(3):208-11.

Khan AU, Musharraf A. Plasmid mediated multiple antibiotic resistance in P. mirabilis isolated from the UTI patients. Medical Sci Mon. 2004;10(11):598-602.

Stamm WE. Urinary Tract Infection and Pylonepritis, In Harrisons Principles of Internal medicine, ed. D. L. Kasper et al., 16th Edition (McGraw Medical Publishing Division, New York, 2005). 1715.

Barnes R, Roddy R, Daifuku R, Stamm W. Urinary tract infection in sexually active homosexual men. Lancet. 1986;327(8474):171-3.

Rosenberger WF. Circumcision and urinary tract infection. JAMA. 1992;268(1):55.

Badri AM, Mohamed SG. Clinical Epidemiology and Antibiogram of UTI Patients Attended Different Hospital in Khartoum, Sudan. Clin Microbiol. 2017;6(5):301.

Ahmed I, Rabbi MB, Sultana S. Antibiotic resistance in Bangladesh: A systematic review. Int J Infect Dis. 2019;80:54-61.

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Published

2021-04-27

How to Cite

Farjana, N. E., Islam, M. A., Zerin, T., & Begum, M. A. (2021). Bacterial association in urinary tract infection and their drug resistance among patients in Rajshahi, Bangladesh. International Journal Of Community Medicine And Public Health, 8(5), 2144–2149. https://doi.org/10.18203/2394-6040.ijcmph20211730

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Original Research Articles