Isolation, Identification and Antibiotic Susceptibility Analysis of Bacterial Pathogens from Suspected Urinary Tract Infected Patients of Tertiary Medical Centre  in Dhaka City, Bangladesh

Md. Robeul Islam ¹, Avijit Banik ¹, Md. Abu Zihad ¹, Kumkum Rahman Mouree ^1* and Suvamoy Datta ¹

Urinary tract infections (UTIs) are common, especially in women. Identifying bacteria causing UTIs helps choose effective treatments, crucial for managing infections.

Abstract

An infection of the urinary tract (kidneys, ureters, bladder, and urethra) is known as a urinary tract infection (UTI). The lower urinary tract, the bladder, and the urethra are the most often infected areas. Women are more likely than males to have a bacterial infection. The aim of the research was to determine the causative agent of UTI in patients and see how they responded to standard treatments.  A total of 435 urine samples were examined using the culture technique. The samples were streaked evenly on blood agar, MacConkey, and then incubated for 24 hours at 37°C. The morphological characteristics of the colony on culture media were used to identify the presumptive bacterium. Gram staining and routine biochemical assays were also used to confirm the findings. On Muller-Hinton agar, the disk diffusion technique was employed to assess susceptibility to 12 different antibiotics. The most prevalent uropathogen was E. coli (44%) samples. The second isolate was Staphylococcus aureus (21%), Klebsiella species (13%) and Proteus species (12%), Enterobacter species (10%). In overall, the uropathogens were highest susceptible to Meropenem (82.2%), Amikacin (63.6%) and Cefixime (59.8%) highest resistance to Azithromycin (84.2%), Gentamycin (75.6%) and Nalidixic acid (64.4%). In both genders and age groups, E. coli was the most common uropathogen (44%). The most successful medications for the treatment of UTI Meropenem (82.2%), Amikacin (63.6%), and Azithromycin (93.15 percent), whereas Azithromycin (84.2%), Gentamycin (75.6%) and Nalidixic acid (64.4%) was the least effective. The present Study can be helpful for the clinicians in finding proper drugs in the developing countries like Bangladesh where multi-drug resistance problem has just complicated the treatment of UTIs.

Keywords: UTI, Uropathogen, Antibiotic Susceptibility, Tertiary Medical Centre.

References

Akram M, Shahid M, Khan AU 2007: Etiology and antibiotic resistance patterns of community-acquired urinary tract infections in JNMC Hospital Aligarh, India. Annals of clinical microbiology and antimicrobials 6(1): 1-7.

Akter T, Fatema K, Alam MR, Parvez MAK, Nahar S, Uddin ME 2016: Investigation of Urine Samples for Isolation, Identification and Antibiotic Susceptibility Analysis of Bacterial Pathogens from Suspected Urinary Tract Infected Patients of Bangladesh. Journal of Advances in Medicine and Medical Research 18(2): 1-10.

Akter T, Fatema K, Alam MR, Parvez MAK, Nahar S, Uddin ME, et al. 2016: Investigation of Urine Samples for Isolation, Identification and Antibiotic Susceptibility Analysis of Bacterial Pathogens from Suspected Urinary Tract Infected Patients of Bangladesh. Journal of Advances in Medicine and Medical Research 18(2): 1-10.

Akter T, Hossain MJ, Khan MS, Sultana H, Fatema K, Al Sanjee S 2016: Isolation, identification and antimicrobial susceptibility pattern analysis of Escherichia coli isolated from clinical samples of Bangladesh. Asian Journal of Biomedical and Pharmaceutical Sciences 6(54): 13.

Al-Dujiaily A 2000: Urinary tract infection during pregnancy in Tikrit. Medical Journal of Tikrit 6(3): 220-224.

Andreu A, Alós JI, Gobernado M, Marco F, de la Rosa M, García-Rodríguez JA 2005: Etiology and antimicrobial susceptibility among uropathogens causing community-acquired lower urinary tract infections: a nationwide surveillance study. Enfermedades infecciosas y microbiologia clinica 23(1): 4-9.

Barnes R, Roddy R, Daifuku R, Stamm W 1986: Urinary-tract infection in sexually active homosexual men. The Lancet 327(8474): 171-173.

Bauer A, Kirby W, Sherris JC, turck 1966: turck, Turck M. Antibiotic susceptibility testing by a standardized single disk method. American journal of clinical pathology 45(4): 493.

Beyene G, Tsegaye W 2011: Bacterial uropathogens in urinary tract infection and antibiotic susceptibility pattern in jimma university specialized hospital, southwest ethiopia. Ethiopian journal of health sciences 21(2): 141-146.

Bonadio M, Meini M, Spitaleri P, Gigli C 2001: Current microbiological and clinical aspects of urinary tract infections. European urology 40(4): 439-445.

Clinical and Laboratory Standards Institute (CLSI) 2013: Performance standard for anti-microbial susceptibility testing. 23rd International Supplement Document 33: 1-199.

Cunha MA, Assunção GLM, Medeiros IM, Freitas MR 2016: Antibiotic resistance patterns of urinary tract infections in a northeastern Brazilian capital. Revista do Instituto de Medicina Tropical de São Paulo 58.

Dromigny JA, Nabeth P, Juergens-Behr A, Perrier-Gros-Claude JD 2005: Risk factors for antibiotic-resistant Escherichia coli isolated from community-acquired urinary tract infections in Dakar, Senegal. Journal of Antimicrobial Chemotherapy 56(1): 236-239.

Farajnia S, Alikhani MY, Ghotaslou R, Naghili B, Nakhlband A 2009: Causative agents and antimicrobial susceptibilities of urinary tract infections in the northwest of Iran. International journal of infectious diseases 13(2): 140-144.

Ferry S, Burman LG, Holm SE 1988: Clinical and bacteriological effects of therapy of urinary tract infection in primary health care: relation to in vitro sensitivity testing. Scandinavian journal of infectious diseases 20(5): 535-544.

Hvidberg H, Struve C, Krogfelt KA, Christensen N, Rasmussen SN, Frimodt-Møller N 2000: Development of a long-term ascending urinary tract infection mouse model for antibiotic treatment studies. Antimicrobial agents and chemotherapy 44(1): 156-163.

Lane DR, Takhar SS 2011: Diagnosis and management of urinary tract infection and pyelonephritis. Emergency medicine clinics 29(3): 539-552.

Sobel JD 1997: Pathogenesis of urinary tract infection: role of host defenses. Infectious disease clinics of North America 11(3): 531-549.

Spach DH, Stapleton AE, Stamm WE 1992: Lack of circumcision increases the risk of urinary tract infection in young men. Jama 267(5): 679-681.

Stamm WE, Hooton TM 1993: Management of urinary tract infections in adults. New England journal of medicine 329(18): 1328-1334.

Stratchounski LS, Rafalski VV 2006: Antimicrobial susceptibility of pathogens isolated from adult patients with uncomplicated community-acquired urinary tract infections in the Russian Federation: two multicentre studies, UTIAP-1 and UTIAP-2. International Journal of Antimicrobial Agents 28: 4-9.

Subramanian M, Ganesapandian S, Singh M, Kumaraguru A 2011: Antimicrobial susceptibility pattern of urinary tract infection causing human pathogenic bacteria. Asian Journal of Medical Science 3(2): 56-60.

Tammana T, Asif M, Selina A, Sazin I, Sayeed K, Jahangir AM 2016: Uropathogenic analysis and commonly used drug sensitivity patterns of the pathogens in Dhaka City, Bangladesh. British Journal of Medical Research 11(1).

Tammana T, Asif M, Selina A, Sazin I, Sayeed K, Jahangir AM, 2016: Uropathogenic analysis and commonly used drug sensitivity patterns of the pathogens in Dhaka City, Bangladesh. British Journal of Medical Research 11(1).

Weber P, Plaisance J, Mancy C 1995: Epidémiologie comparée de la résistance aux fluoroquinolones chez les Enterobacteriaceae, Staphylococcus, Pseudomonas aeruginosa en médecine de ville. La Presse médicale 24(21): 979-982.

Wing DA, Park AS, DeBuque L, Millar LK 2000: Limited clinical utility of blood and urine cultures in the treatment of acute pyelonephritis during pregnancy. American journal of obstetrics and gynecology 182(6): 1437-1441.

Wong ES, Stamm WE 1983: Sexual acquisition of urinary tract infection in a man. Jama 250(22): 3087-3088.

Wullt B, Bergsten G, Connell H, Röllano P, Gebretsadik N, Hull R, 2000: P fimbriae enhance the early establishment of Escherichia coli in the human urinary tract. Molecular microbiology 38(3): 456-464.