Causative agents of urinary tract infections and their antimicrobial susceptibility patterns at a referral center in Western India: An audit to help clinicians prevent antibiotic misuse

BACKGROUND: Urinary tract infections (UTIs) remain one of the most common infections in community and susceptibility of uropathogens to commonly used antimicrobials has declined over years. It is important to periodically study susceptibility patterns of uropathogens, so that empiric treatment can be determined using recent data, helping improve patient outcomes. METHODS: Urine samples received by the laboratory for culture and susceptibility testing over a period of 3 months were analyzed and included in this study. Antimicrobial susceptibility testing was done on cultured isolates. RESULTS: Of total 3,151 urine samples received, 3,066 were processed, and organisms were isolated from 1,401 (45.69%) samples. Isolation rate from male and female urine samples was 45.29% and 46.32%, respectively. The most commonly isolated organism was Escherichia coli (36.11%), followed by Candida spp. (18.56%), and Klebsiella spp. (18.06%). E. coli was most susceptible to meropenem (91.89%) and imipenem (91.69%). Klebsiella spp. was most susceptible to imipenem(75.89%) and meropenem(75.49%). Susceptibility of E. coli and Klebsiella spp. to nitrofurantoin, cotrimoxazole, and ciprofloxacin was 72.33%, 32.02%, and 18.97%, and 51.77%, 27.27%, and 22.13%, respectively. Candida spp. was most susceptible to amphotericin B (97.30%). CONCLUSION: Treatment for UTIs should be determined based on current local antimicrobial susceptibility patterns of uropathogens to minimise therapeutic failures and prevent antibiotic misuse.