Uropathogens And Their Evolving Antimicrobial Resistance Patterns In Urinary Tract Infections: A Study From A Tertiary Care Hospital In Dhaka, Bangladesh

Abstract

Background: Urinary tract infections (UTIs) rank among the most prevalent bacterial infections in humans. The pathogens responsible for UTIs differ by region and also exhibit varying resistance patterns. Objective: This research aimed to identify the most frequent causative agents, assess their distribution, and analyze the resistance patterns of bacterial strains isolated from UTI patients at a tertiary care hospital in tertiary care hospital, Dhaka. Methods: Urinary isolates from symptomatic UTI patients were identified using conventional techniques. Antimicrobial susceptibility testing was conducted using the Kirby Bauer disk diffusion method. Results: Out of 17139 samples tested, 5266 demonstrated growth of organisms, with E. coli being the most common (53.97%), followed by Klebsiella species (17.89%). The majority of isolates were obtained from female patients within the reproductive age group. E. coli and Klebsiella spp. exhibited significant resistance to Amoxicillin, third-generation cephalosporins, and Ciprofloxacin, while showing the highest sensitivity to Meropenem and Nitrofurantoin. Among gram-positive bacteria, notable resistance was found against Amoxicillin, with all isolates being sensitive to Vancomycin. Conclusion: The findings of this study indicate that UTIs are more prevalent in females, particularly those of reproductive age. E. coli emerged as the leading bacterial pathogen. Urinary pathogens displayed resistance to commonly prescribed antibiotics such as Amoxicillin, third-generation cephalosporins and Ciprofloxacin. Given the good sensitivity observed for Nitrofurantoin across all organisms, it is recommended for use in empirical treatment of UTIs.