CHANGES IN URINARY ISOLATES AND THEIR ANTIBIOTIC RESISTANCE PATTERN

A total of 338 urinary isolates were studied at AFMC, Pune during 1998 for species identification and antibiotic resistance. Out of 145 community isolates E coli were 67% followed by Staph aureus (11%). The hospital isolates of E coli and Proteus spp showed higher resistance to ampicillin (81% and 89% respectively) than to cefotaxime (23% and 22% respectively). K pneumoniae showed relatively higher resistance to cefotaxime i.e. 54% for community strains and 75% for hospital strains. Proteus spp showed higher resistance to fluoroquinolones i.e. 78% for norfloxacin and 82% for ofloxacin as compared to other coliforms and Pseudomonas aeruginosa. Among aminoglycosides bacterial resistance to amikacin is less than to commonly used netilmicin and gentamicin. Hospital isolates of K pneumoniae are 100% resistant to sulphamethoxazole and to trimethoprim. Susceptibility testing is emphasized as a must both for hospital and community isolates, but when empirical treatment is contemplated for community isolates nitrofurantoin, nalidixic acid, amikacin, cefotaxime, gentamicin and piperacillin are recommended as first line choices and for hospital isolates amikacin, cefotaxime and netilmicin are recommended until susceptibility report is available.