Exploring the Trends and Spectrum of UTI-Causing Uropathogenic Bacterial Profiles and Their Antibiotic Susceptibility Patterns: A 4-Year Retrospective Study in Western Maharashtra

Amol Bausakar; Neha Singh; Preeti Rai; Pallavi Sharma; R Mahesh Reddy

doi:10.21276/apalm.3593

Authors

Amol Bausakar Department of Microbiology, Armed Forces Medical College, Pune, Maharashtra, India
Neha Singh Department of Microbiology, Armed Forces Medical College, Pune, Maharashtra, India
Preeti Rai Department of Microbiology, Military Hospital Jalandhar, India
Pallavi Sharma Department of Microbiology, Armed Forces Medical College, Pune, Maharashtra, India
R Mahesh Reddy Department of Microbiology, Armed Forces Medical College, Pune, Maharashtra, India

DOI:

https://doi.org/10.21276/apalm.3593

Keywords:

Uropathogens, Antibiotic susceptibility, Carbapenem-Resistant Enterobacterales (CRE)

Abstract

Background: Urinary tract infections (UTIs) are one of the most common and prevalent healthcare challenges worldwide, caused by uropathogens. This abstract summarizes recent research on UTI-causing uropathogens and their antibiotic susceptibility trend in a tertiary hospital over the period of four years. The study will help improve resistance surveillance and antibiotic policies, ultimately enhancing patient outcomes.

Methods: A retrospective study was conducted in a tertiary care hospital for a period of 4 years (2020-2023). 21,330 urine samples of patients with UTI-like symptoms were subjected to bacterial cultures. Samples with significant bacteriuria were subjected to identification and antibacterial susceptibility testing using the VITEK® 2 COMPACT System.

Result: Of 21,330 samples, 5,211 (24.43%) showed significant bacteriuria, with Escherichia coli (49.75%) being the most common uropathogen, followed by Klebsiella pneumoniae (24.69%), Pseudomonas aeruginosa (8.01%), and Enterococcus spp. (5.49%). Carbapenem-resistant K. pneumoniae isolates increased significantly from 33.21% (2020) to 59.96% (2023), while no significant rise was observed in Carbapenem-resistant E. coli and P. aeruginosa isolates. Resistance to Vancomycin (13.75%), Linezolid (9.99%), and Teicoplanin (8.12%) in Enterococcus species remained stable over four years. Resistance rates in ICU isolates were higher than those in outpatients and non-ICU inpatients.

Conclusion: E. coli, K. pneumoniae, Enterococcus spp., and P. aeruginosa were the most common pathogens causing UTIs in our region. The bacterial species and antimicrobial resistance patterns seen in uropathogens varied across different patient populations that visited the tertiary care hospital. Strengthening and improving the monitoring and surveillance of bacterial resistance is very essential to minimize the spread and evolution of multi-drug-resistant organisms.

References

1. Flores-Mireles AL, Walker JN, Caparon M, Hultgren SJ. Urinary tract infections: epidemiology, mechanisms of infection and treatment options. Nat Rev Microbiol. 2015;13(5):269-84.

2. Duicu C, Cozea I, Delean D, Aldea AA, Aldea C. Antibiotic resistance patterns of urinary tract pathogens in children from Central Romania. Exp Ther Med. 2021;22(1):748.

3. Bhonsle KS, Vyas A, Vyas H, Ramchandani A, Hemwani K. Prevalence, identification and frequency of uropathogens causing urinary tract infection in children in Ujjain (M.P.). Indian J Microbiol Res. 2022;9(2):131-134.

4. Gandhi VP, Patel M, Nerurkar A. Bacteriological profile and its antibiotic susceptibility in patients with Urinary Tract Infection at Tertiary Care Hospital, Valsad, Gujarat. IP Int J Med Microbiol Trop Dis. 2017;3(2):57-60.

5. Reza Mortazavi-Tabatabaei S, Ghaderkhani J, Nazari A, Sayehmiri K, Sayehmiri F. Pakzad I. Pattern of antibacterial resistance in urinary tract infections: A systematic review and meta-analysis. Int J Prev Med. 2019;10:169.

6. Li J, Jiang F, Xie A, Jiang Y. Analysis of the Distribution and Drug Resistance of Pathogens in Patients with Urinary Tract Infection in the Eastern Chongming Area of Shanghai from 2018 to 2020. Infect Drug Resist. 2022:15:6413-6422.

7. Prakash D, Saxena RS. Distribution and antimicrobial susceptibility pattern of bacterial pathogens causing urinary tract infection in urban community of meerut city, India. ISRN Microbiol. 2013 Oct 29:2013:749629.

8. Hassan SA, Ahmed YMA, Hassan GD. Antimicrobial susceptibility of Escherichia coli isolated from diabetic patients in Mogadishu, Somalia. Front Microbiol. 2023 Aug 24:14:1204052.

9. Li Y, Zou M, Yan Q, et al. Trend of distribution and antimicrobial resistance in uropathogens in China from the CHINET antimicrobial resistance surveillance program, a 7-year retrospective study. One Health Adv. 2024;2:16.

10. Prakash D, Saxena RS. Distribution and antimicrobial susceptibility pattern of bacterial pathogens causing urinary tract infection in urban community of Meerut city, India. ISRN Microbiol. 2013;:2013:749629.

11. Vignesh R, Babu A, Joseph NM, Sistla S, Parija SC. Antimicrobial susceptibility pattern of Enterococcus species isolated from urinary tract infections. J Clin Diagn Res. 2014:8(10):DC23-DC25.

12. Meletis G. Carbapenem resistance: Overview of the problem and future perspectives. Ther Adv Infect Dis. 2016;3:15-21.

13. Indian Council of Medical Research. Annual Report 2022: ICMR Antimicrobial Resistance Surveillance and Research Network (AMRSN) [Internet]. New Delhi: ICMR: 2023. Available from: https://main.icmr.nic.in/sites/default/files/reports/AMRSN_Annual_Report 2022.pdf

14. Tamma PD, Aitken SL, Bonomo RA, Mathers AJ, van Duin D, Clancy CJ. Infectious Diseases Society of America 2022 Guidance on the Treatment of Extended-Spectrum 3-lactamase Producing Enterobacterales (ESBL-E), Carbapenem-Resistant Enterobacterales (CRE), and Pseudomonas aeruginosa with Difficult-to-Treat Resistance (DTR-P. aeruginosa). Clin Infect Dis. 2022 Aug 25 75(2):187-212.

15. Medina-Polo J, Naber KG, Bjerklund Johansen TE. Healthcare-associated urinary tract infections in urology. GMS Infect Dis. 2021:9:Doc05.