Prevalence and Susceptibility of Uropathogens: a Recent Report from a Teaching Hospital in Bangladesh

Background: This investigation was aimed to determine the current status of prevalence and antimicrobial susceptibility of uropathogens isolated in a teaching hospital in Bangladesh. A retrospective analysis was done at the department of Microbiology of Islami Bank Medical College, Rajshahi (IBMCR), Bangladesh during January to December, 2012. Midstream clean-catch urine samples were collected from 443 suspected urinary tract infection patients of different age and sex groups. Uropathogens were identified by standard and specific microbiological techniques and antimicrobial susceptibility pattern was determined by Kirby Bauer Disc diffusion method following Clinical and Laboratory Standards Institute (CLSI) guidelines.

Findings: Culture yielded a total of 189 (42.66%) significant growths of uropathogens including 179 (94.71%) unimicrobial (single bacterial species) and 10 (5.29%) polymicrobial (pair of two different bacterial species) growths. Gender distribution showed 34.44% male and 48.29% female UTI patients with male to female ratio of 1:1.46, respectively. E. coli was the predominant isolate (59.30%), followed by Staph saprophyticus (19.09%), Enterococcus spp. (11.56%), Klebsiella spp. (5.53%), Pseudomonas spp. (2.01%), Proteus spp. (1.51%) and Enterobacter spp. (1.00%). Very high frequency of resistance ranging from 72.03 to 91.53% to cotrimoxazole, ciprofloxacin, cefuroxime, cephradin, amoxicillin and nalidixic acid, moderately high resistance to ceftriaxone (55.08%) and gentamicin (40.68%) and low resistance to nitrofurantoin (16.10%) were shown by E. coli. Similarly, Staph. saprophyticus and Enterococcus spp. showed low resistance (18.42 and 21.74%) to nitrofurantoin, but moderately high against cefaclor, gentamycin, cefuroxime and ceftriaxone. Klebsiella spp. and Proteus spp. were 72.73 and 66.67% susceptible, respectively to gentamycin only but low frequency of susceptibility (<50%) was found to all other antimicrobial agents. Peudomonas spp. was 75% susceptible to nitrofurantoin only and showed 75-100% resistance to all other agents. Enterobacter spp. were 50% resistant to nitrofurantoin, gentamycin, cefuroxime, cefaclor and ceftriaxone but showed 100% resistance to all remaining antimicrobials.

Conclusions: Current uropathogens showed the highest rate of susceptibility to nitrofurantoin and gentamicin which can be adapted for empirical treatment of urinary tract infections.