BACTERIA CAUSING COMMUNITY – ACQUIRED URINARY TRACT INFECTIONS AND THEIR ANTIMICROBIAL SUSCEPTIBILITY PATTERN IN PATIENTS ATTENDING OUTPATIENT DEPARTMENT IN TERTIARY CARE HOSPITAL

Introduction: Community acquired urinary tract infection is defined as urinary tract infection occurring in outpatient setting, or in < 48 hrs after hospitalization, with no recent past history of urological procedure or catheter insertion. However, in almost all cases of community acquired urinary tract infection, antibiotic therapy is prescribed empirically before urine culture. Further there is increase in resistance to fluoroquinolones, ampicillin, and cephalosporin in bacteria causing community acquired UTI. Clinicians should be aware of sensitivity pattern of organisms causing community to acquire UTI. Material and Method: This retrospective study was conducted from 1/5/2024 to 15/9/2024 after obtaining approval from IEC committee. Patients who visited outpatient department and diagnosed themselves as UTI are included in this study. Hospitalized patient (> 48 hrs. admission), patient with catheter associated infection, patients recently undergone urological procedure were excluded from the study Urine cultures were done in our laboratory according to standard techniques. Antimicrobial susceptibility tests were performed using Kirby-Bauer’s disk diffusion method. Result: Out of 115 urine specimens, 80 samples were positive for bacterial growth with significant bacteriuria. Total 64-gram negative pathogens and 16-gram positive pathogens identified. The predominant uropathogen isolated among gram negative bacteria was E. coli 47(73.43%), Klebsiella pneumoniae 13(20.31%), P. aeruginosa 3(4.68%) and Proteus mirabilis 1(1.5%). The predominant bacterial isolates among gram positive pathogens were Coagulase negative Staphylococci 8(50%), E. faecium 7(43.75%), MRSA 1(6.25%). In our study, E. coli strains showed highest susceptibility to fosfomycin 80.85%, Amikacin 78.72%, gentamicin 72.34%, and ertapenem 70.21% respectively. In our study, predominant gram-positive organism identified was Coagulase negative staphylococci with 50% susceptibility to Teicoplanin, Tigecycline, Nitrofurantoin. Conclusion: Community acquired infection remains most common bacterial infection occurring in community setting affecting individuals across all age groups for which empirical antibiotic administration is initiated. The increasing resistance to antibiotics such as ampicillin, cephalosporin, and quinolones have limited the use of these drugs in the treatment. Early diagnosis, appropriate antimicrobial therapy and implementation of preventive measures are crucial to reduce the burden of community acquired urinary tract infection. Periodic surveillance studies are recommended to guide empirical therapy and support antibiotic stewardship program in clinical settings.