TMSS Medical College Journal

Background: Urinary tract infection is one of the commonest disease of the community and hospitals resulting in high rates of morbidity and economic burden associated with its treatment. Urinary tract infecion (UTI) is caused by both gram positive and negative bacteria but most common agents are the gram negative bacilli. Distribution of urinary pathogens and their resistance pattern to antimicrobial drugs vary regionally and even in the same region. Objective: The aim of the study is to isolate and identify the uropathogens causing UTI & to see the antibiotic susceptibility pattern of the uropathogens in the region. Materials and Methods: This study has been carried out in the Department of Microbiology of Rajshahi Medical College in the period from july 2014 to june 2015. Midstream urine were processed for microscopy and culture and the pathogens were identified by standard methods. Antimicrobial sensitivity was carried out by Kirby-Bauer disc diffusion method according to clinical and laboratory standards institute guidelines. Results: Out of 254 urine samples, 96(37.79%) shows significant growth and among them E.coli 66(68.75%) was the most prevalent gram negative bacilli followed by Klebsiella spp. 6(6.25%), Enterobacter spp. 4(4.16%) and Citrobacter spp.4(4.16%). Pseudomonas spp. 6(6.25%), Proteus spp. 5 (5.20%) and in gram positive cocci group staph. Saprophyticus 3(3.12%) and Staph.aureus 2 (2.08%). Out of 96 positive bacterial strains 59(61.45%) were resistant to multiple groups of antibiotics. A good number of gram negative isolates were resistant to commonly used drugs such as ampicillin, ceftazidime, cephradine, ciprofloxacin, co-trimoxazole.azithromycin and fewer number are moderately resistance to imipenem, amikacin and nitrofurantoin. Conclusion: Escherichia coli is still the most common uropathogen and the antibiotic selection is very difficult without antibiogram due to wide range of resistance of commonly used drugs which have been used previously. Since most UTIs are treated empirically. Therefore there is a need for periodic monitoring of actiologic agents of UTI and their resistance pattern in this community.

Urinary tract infection is one of the commonest disease of the community and hospitals resulting in high rates of morbidity and economic burden associated with its treatment. Although UTI’s are encountered in both sexes and all ages, but it is commoner in females. Out of every two female one has suffered from a urinary infection at least once in her life; 12% with an initial infection and 48% with a recurrent episodes’. Frequent (3-6 per year) recurrences of infection follow the initial Episode, producing additional morbidity and time lost from work. The principal reservior of infectious agents for urinary tract is the flora of the bowel, external genitalia, perineal and perianal regions. Most UTI is caused by a single pathogen, usually enteric gram-negative bacteria originating from the fecal flora of the host. Escherichia coli is responsible for approximately 80% of all nosocomial and >90% of all community aequired infections.