PREVALENCE AND ANTIMICROBIAL SUSCEPTIBILITY OF GRAM-NEGATIVE BACTERIA IN THE URINE SAMPLE OF DIABETIC PATIENTS IN TERTIARY CARE HOSPITAL

To determine the prevalence and antimicrobial susceptibility patterns of Gram-negative uropathogens isolated from diabetic patients with urinary tract infection (UTI) attending a tertiary care hospital in Namakkal, Tamil Nadu. A hospital-based cross-sectional study was conducted on 225 midstream urine samples collected from clinically suspected diabetic UTI patients, of which 132 showed significant bacteriuria. Bacterial identification was carried out using standard microbiological methods. Antimicrobial susceptibility testing was performed by the Kirby–Bauer disc diffusion method following CLSI 2023 guidelines, and extended-spectrum β-lactamase (ESBL) production was evaluated. Gram-negative bacteria constituted the majority of uropathogens. Escherichia coli was the most frequently isolated organism, followed by Klebsiella pneumoniae and Pseudomonas aeruginosa. Carbapenems and amikacin demonstrated the highest antimicrobial activity, whereas commonly prescribed oral antibiotics such as ampicillin, ciprofloxacin, and cotrimoxazole showed poor effectiveness. A considerable proportion of isolates were ESBL producers, indicating a high burden of multidrug resistance. UTIs were more prevalent among female diabetic patients, particularly those with longer disease duration. These findings highlight the predominance of multidrug-resistant Gram-negative uropathogens in diabetic UTIs and emphasize the importance of routine culture-guided therapy to ensure effective treatment and limit the emergence of resistance.