ANTIMICROBIAL SUSCEPTIBILITY PATTERN OF PATHOGENIC BACTERIA CAUSING URINARY TRACT INFECTION IN TERTIARY CARE HOSPITAL IN KATHMANDU, NEPAL

Urinary tract infection (UTI) is one of the common clinical conditions in patients presenting to the tertiary care hospital. In general, most of the case of UTI was being treated by empirical antimicrobial therapy before the laboratory results of urine culture; since the antimicrobial susceptibility test of uropathogenic bacteria and antibiotic resistance for enhanced management of UTI with a commonly used antibiotic. A prospective observational study was conducted on significant bacteria isolated from the urine samples submitted in microbiology unit from April 2017 to September 2017 at tertiary care hospital in Kathmandu, Nepal. E. coli (52.5%); the predominant etiological organism of UTI in our study showed high sensitivity to nitrofurantoin (93.3%), meropenem (92.9%), and colistin (82.3%). The most effective antimicrobial agent against Gram-positive Enterococcus species were linezolid (100%), vancomycin (100%) and nitrofurantoin (100%). A very high rate of resistance was seen against amikacin (75%), nalidixic acid (68.7%), and cotrimoxazole (63.9%) in Gram-negative bacilli isolates of E. coli. Escherichia coli, the most common uropathogens isolated more commonly from the female (66%) patients compared to the male (34%) patients and isolation of E. coli among female patients is statistically significant (p<0.05), whereas isolation of Pseudomonas aeruginosa (83.3%), Acinetobacter spp. (100%) and Enterococcus spp. (80%) among male patients is statistically significant (p<0.05). This study justifies the necessity to treat patients with UTI based on antimicrobial susceptibility test results in order to prevent the evolution of resistant pathogens. Since UTI has a large impact on the socio-economy & emergence of bacterial resistance, periodic surveillance of antibiotic susceptibility is strongly recommended.