Resistance Patterns in Uropathogens; A Prospective Study of Antibiotic Sensitivity in UTIs and Pyelonephritis
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Abstract
Background: Urinary tract infections (UTIs) and pyelonephritis are prevalent infections, increasingly complicated by antibiotic-resistant uropathogens, which challenge effective treatment and patient outcomes. Objective: This study aimed to evaluate resistance patterns in uropathogens and assess antibiotic sensitivity in patients with UTIs and pyelonephritis treated at Naogaon Medical College, Bangladesh. Method: This prospective study included 318 patients diagnosed with UTIs and pyelonephritis from January to December 2023 at the Department of Nephrology, Naogaon Medical College, Bangladesh. Urine samples were cultured to isolate uropathogens, and antibiotic susceptibility was tested using the disk diffusion method. Resistance patterns were analyzed for common antibiotics, including trimethoprim-sulfamethoxazole, nitrofurantoin, and ciprofloxacin. Results: Among the 318 patients, Escherichia coli (E. coli) was the most frequently isolated pathogen (64%), followed by Klebsiella pneumoniae (18%) and Proteus mirabilis (10%). Resistance to trimethoprim-sulfamethoxazole was observed in 55% of E. coli isolates, while nitrofurantoin and fosfomycin demonstrated resistance rates of 28% and 12%, respectively. Ciprofloxacin resistance was detected in 43% of isolates. Extended-spectrum beta-lactamase (ESBL) production was detected in 22% of E. coli and 15% of K. pneumoniae isolates. Carbapenem resistance was low (5%), but concerning for future treatment options. Conclusion: The study highlights significant antibiotic resistance in uropathogens, particularly E. coli, complicating the empirical treatment of UTIs and pyelonephritis. Effective local antimicrobial stewardship is crucial to address resistance trends and optimize patient outcomes.
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