TMSS Medical College Journal

Background: Urinary tract infection (UTI) is one of the common infections in the community and hospital. Bacterial distribution and susceptibility of UTI changes according to time and place. Objective: This study was conducted to determine the bacterial distribution and antimicrobial susceptibility of common uropathogen in a tertiary care hospital of Bangladesh. Methodology: Clean catch midstream urine samples were collected from 494 patients irrespective of the age and sex. Isolation of both gram positive and gram negative bacteria by standard culture technique and identification was done on the basis of their cultural and gram staining smear made from culture colonies and biochemical characteristics. Antimicrobial susceptibility was performed in common isolated bacteria by Kirby Bauer's disc diffusion method. Results: Among the 494 sample, 212 showed culture positive(42.9%) and Gram negative bacteria (94.3%) were found in high prevalence and Escherichia coli (58,96%) was the most prevalent gram negative isolates. Nalidixic acid(83.4%) and ciprofloxacin(88.4%) were found the most resistant and Imipenem and Nitrofurantoin were found the most susceptible drugs against isolated Escherichia coli which showed 94.1% and 87.5% susceptibility, respectively. Conclusion: Escherichia coli is the most common bacteria causing UTI in both sexes and irrespective of age. Imipenem, Nitrofurantoin and Amikacin are the most sensitive, Nalidixic acid, ciprofloxacin, cefuroxime and cephradine are the most resistant antibiotics.

Urinary tract infection (UTI)is the commonest bacterial infectious disease in community practice with a high rate of morbidity and financial cost.It has been estimated that annually 150 million people were infected with UTI worldwide which costing global economy more than 6 billion US dollars1.UTI can affect lower and sometimes both lower and upper urinary tracts.The treatment of UTI can be classified into uncomplicated and complicated on the basis of their choice of treatment2.UTI is more common in females than in males as female urethra structurally found less effective for preventing the bacterial entry3.It may be due to the proximity of the genital tract and urethra4 and adherence of urothelial mucosa to the mucopolysaccharide linings.The other main factors which make females more prone to UTI are pregnancy and sexual activity In pregnancy, the physiological increase in plasma volume and decrease in urine concentration develop glycosuria in up to 70%women which ultimately leads to bacterial growth in urine7. The spectrum of bacteria causing complicated UTI is much broader than of those causing uncomplicated UTI.However,the most commonly encountered bacteria are gram negative of which Escherichia coli,Citrobacter spp., Enterobacter spp.,Klebsiella spp.,Pseudomonas aeruginosa,and Proteus spp.,whereas gram positive Staphylococcus aureus,and Candida spp. are found rarely.