Pattern of urinary tract infection in Kashmir and antimicrobial susceptibility

Antibiotic resistance of urinary tract pathogens has increased worldwide. The purpose of this study is to provide information regarding the causative agents of urinary tract infection in Kashmiri patients, identify the uropathogens responsible for the infection and study the antibiotic susceptibility patterns of the uropathogens. Clean voided mid-stream urine samples were collected from 2190 patients. The specimens were cultured and the isolates were identified using standard microbiological techniques. The antibiotic susceptibilities of the isolates were also determined. Of 2190 specimens, 591 (27%) showed significant growth upon culture. Approximately 84.1% (497/591) of the 591 patients with UTI were females, most of which belonged to the 21-30 age group (206). The males accounted for 15.9% (94/591) UTI cases. Most of the male patients belonged to the 21-30 age group (34). The lowest incidence of urinary tract infections was seen among the 13-20 years age group. Throughout this study males accounted for only 16% of all UTI cases. Escherichia coli was the most predominant isolate, 53.8% followed by Klebsiella pneumoniae 22.4% and Pseudomonas aeruginosa 7.6%. All isolates were fully sensitive to ofloxacin, and more than 94% were sensitive to cefuroxime. Apart from group D Streptococcus, the overall response to ampicillin by all isolates was less than 15%. The prevalence of multi-resistant Pseudomonas aeruginosa in community-acquired urinary tract infections is increasing. All Pseudomonas aeruginosa isolates were fully susceptible to cefuroxime and ofloxacin. It is recommended that cefuroxime and ofloxacin or both are used in the blind treatment of urinary tract infection while awaiting the culture and sensitivity results. Concurrent with the necessary shift in the prescription pattern, attention should be paid to restriction of antibiotic abuse in the community to retard development of further drug resistance.