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Antibiotic resistance pattern in uropathogens.

V Gupta1, A Yadav, R M Joshi

  • 1Dept. of Microbiology, Govt. Medical College Hospital, Sector 32, Chandigarh - 160 047, India.

Indian Journal of Medical Microbiology
|July 28, 2007
PubMed
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Antibiotic resistance in uropathogens varies between hospital inpatients and outpatients. Outpatient urinary tract infections may respond to older antibiotics, while inpatient infections require newer agents due to high drug resistance.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Clinical Pharmacy

Background:

  • Urinary tract infections (UTIs) are common, caused by various uropathogens.
  • Antibiotic resistance patterns differ significantly between community-acquired and hospital-acquired infections.
  • Effective empirical treatment of UTIs requires up-to-date knowledge of local resistance trends.

Purpose of the Study:

  • To investigate the antibiotic susceptibility profiles of common uropathogens isolated from inpatient and outpatient departments.
  • To compare the resistance patterns between uropathogens causing community-acquired UTIs and nosocomial infections.
  • To provide evidence-based recommendations for appropriate antibiotic therapy for UTIs.

Main Methods:

  • Prospective study of uropathogenic bacterial isolates from urine samples collected between April 1997 and March 1999.

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  • Identification of bacterial species including Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Proteus mirabilis, Acinetobacter baumanii, and Enterococcus faecalis.
  • Antibiotic susceptibility testing was performed using standard microbiological methods.
  • Main Results:

    • Outpatient isolates showed susceptibility to first-generation cephalosporins, nitrofurantoin, and fluoroquinolones (norfloxacin/ciprofloxacin).
    • Inpatient isolates, associated with nosocomial UTIs, exhibited high-level resistance to multiple antibiotics.
    • High resistance rates to trimethoprim-sulfamethoxazole (co-trimoxazole) were observed in both inpatient and outpatient uropathogens.

    Conclusions:

    • Antibiotic selection for UTIs should be guided by patient setting (inpatient vs. outpatient) due to differing resistance profiles.
    • Empirical treatment for nosocomial UTIs may require parenteral administration of newer aminoglycosides or third-generation cephalosporins.
    • Routine urine culture and sensitivity testing are crucial before initiating antibiotic therapy to ensure optimal treatment outcomes and combat antimicrobial resistance.