ANTI-MICROBIAL RESISTANCE AND SENSITIVITY PATTERNS OF E.COLI, AMONG ADULT PATIENTS WITH URINARY TRACT INFECTIONS AT DHQ HOSPITAL, ORAKZAI DISTRICT, KHYBER PAKHTUNKHWA, PAKISTAN - A CROSS-SECTIONAL STUDY
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Keywords
Urinary tract infections, (UTI), Escherichia coli, antimicrobial resistance
Abstract
Background: Urinary tract infections (UTI) are among the most common and serious public health problems worldwide, being primarily caused by Escherichia coli. Treatment strategies are being complicated by an increasing incidence of antimicrobial resistance (AMR).
Objectives: The objective of this cross-sectional study was to determine the frequency, Prevalence and antimicrobial resistance patterns among urinary tract infections (UTIs) in adult patients at District Headquarters Hospital Orakzai Khyber Pakhtunkhwa Pakistan.
Methods: During May – June 2023, a total of adult patients with clinical suspicion to UTIs (n= 130) were included. We performed ordinary microbiological urine culture and identification of isolated bacteria. Antibiotic susceptibilities were performed in accordance to the guidelines of the Clinical and Laboratory Standards Institute (CLSI) by Kirby-Bauer disc diffusion method.
Results: The frequency of UTIs was 26.6%, and Ecoli were the responsible pathogens in 92% of positive cultures. The most striking finding: 80% of E. coli isolates made an enzyme called extended-spectrum beta-lactamases (ESBLs). Antibiogram analysis showed that amikacin ( 85.1 %), fosfomycin(85%), imipenem (92.5%), ertapenem (92.5% ), cefoperazon/sulbactam(88%) and piperacilin/tazobactam were highly sensitive against E.coli. On the other hand, high rate of cefepime (81 %), ceftriaxone (88.8%), ceftazidirne( 77%) and cefotaxime resistant isolates were noticed.
Conclusions: The changing spectra of antimicrobial resistance highlights the importance of ongoing monitoring for trends in susceptibility. These are important steps to help direct empiric therapy for UTIs.
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Hameed Badshah
Resident Internal Medicine, Saidu Group of Teaching Hospital, Swat.
Saiyad Ali
House Officer, Saidu Group of Teaching Hospitals, Swat
Tauseef Hamid
House Officer, Saidu Group of Teaching Hospitals, Swat
Shafiq Ur Rahman
House Officer, Saidu Group of Teaching Hospitals, Swat