Antibiotic resistance pattern among in-patients of urinary tract infection at tertiary care hospital of coastal Karnataka- a retrospective study

The main determinant of empiric treatment of urinary tract infections (UTI) is antibiotic sensitivity patterns of uropathogens in a population. The patterns of resistance among uropathogensin tertiary care hospital in South India can help establish local guidelines on treatment of UTI. A retrospective observational study was conducted at Kasturba Hospital, Manipal, from 1st Jan 2012 to 31st Dec 2012. The case records of 500 patients of either sex who were admitted to Kasturba Hospital, Manipal with diagnosis of UTI were studied. Sensitivity testing was done in each isolate. E.coli comprised 64%; Klebsiella 16%; Proteus 3.7%; Pseudomonas 6.15%; Staphylococcus 2.8%; and Enterococcus 4.92% of the isolates. Extendedspectrum beta-lactamase (ESBL) producers among E coli, Klebsiella and Proteus were 63.41%, 53.84% and 33.33% respectively.E.coli was highly resistant to amoxicillin-clavulanate (67.8%), and ciprofloxacin (67%) whereas it was least resistant to imipenem (1%), cefoperazone-sulbactam (3.9%) and amikacin (9.8%). Klebsiellawas highly resistant to ciprofloxacin (69.2%) whereas it was least resistant to imipenem (0%) and cefoperazone-sulbactam (3.2%). Proteus was highly resistant to amoxicillin-clavulanate (67.3%) and ceftriaxone (66.7%), whereas it was least resistant to cefoperazone-sulbactam (0%), imipenem (12.5%), amikacin (16.7%) and netilmicin (16.7%). High prevalence of extended spectrum beta lactamase (ESBL) producers among uropathogens were seen in our study. Moreover, alarming rate of resistance to ampicillin, amoxicillin-clavulanate and ciprofloxacin should prevent the use of these commonly used antibiotics for empiric treatment of UTI.