Urinary Tract Infection in Diabetics - A Five Year Retrospective Study on the Prevalence of Bacterial Isolates and its Antibiotic Susceptibility Patterns in A Tertiary Care Hospital in South India
Journal Title: International Journal of Contemporary Medical Research - Year 2018, Vol 5, Issue 4
Abstract
Introduction: Urinary tract infection (UTI) is almost most common seen infection in the diabetic patient due to various local and systemic immunopathogenetic reasons. This causes multiple renal and extrarenal complications and even death if not intervened early. We aimed to find out the prevalence of different bacteria in urine culture and the antibiotic susceptibility pattern amongst diabetic patients admitted in our hospital and to start empirical antibiotics for early recovery and to prevent complications. Material and Methods: Retrospectively, 651 culture positive urine samples were taken for study with inclusion and exclusion criteria. We saw all the case records and investigations of every subject to correlate with criteria of selection. Our laboratory follows the standard protocols for urine sampling, timely transportation and microbiological study. Antibiotic susceptibly was tested by Kirby Bauer method and interpretations were done by clinical laboratory and standards institute (CLSI) guidelines. Results: Out of total 651 patients most commonly affected age group was 51-60 years (30.26%).Here males (53.3%) dominated females (46.7%) in number with little difference. Most common Gram-negative bacteria were Escherichia coli (69.12%) and Klebsiella pneumoniae (8.60%) while most common Gram-positive bacteria were Enterococcus faecalis (10.90%) and Staphylococcus aureus (2.91%).Most of the gram-negative bacteria were having a good susceptibility to amikacin, piperacillin/tazobactam, cefoperazone/sulbactam and carbapenems while Gram-positive bacteria were mostly sensitive to nitrofurantoin, linezolid and vancomycin. Conclusion: in our study, the occurrence of UTI among the diabetic is commoner in the sixth decade with a male predominance. We found E.coli, E.faecalis, and K.pneumoniae as the most commonly grown organisms in descending order. Most of the Gram-negative isolates were susceptible to amikacin, piperacillin/tazobactam, cefoperazone/sulbactam and carbapenems, while most of the Gram-positive cocci were sensitive to nitrofurantoin, linezolid, and vancomycin. Antibiotic resistance is seen very commonly in our setup. We cannot depend upon frequently used oral antibiotics and certain groups like fluoroquinolones and cephalosporin (except for sulbactam containing ones) and ampicillin for empirical treatment in UTI especially the complicated ones.
Authors and Affiliations
Jagadeeswaran G, Mohammad Zeya Ansari, Tolstoy Rajangam
Keywords
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