ANTIMICROBIAL SUSCEPTIBILITY PATTERN OF Escherichia coli ISOLATES OF URINARY TRACT INFECTION FROM PATIENTS VISITING A TERTIARY CARE HOSPITAL OF MORANG, NEPAL

Abstract

Antibiotic resistance among uropathogens is an emerging public health problem. Bacteria may be innately resistant or may acquire resistance to antibiotics. Culture and antibiotics susceptibility testing of urine is an important tool for the diagnosis of infection and monitoring antibiotic resistance patterns of uropathogen. The objective of this study was to isolate and identify Escherichia coli and assess their antibiotic resistance pattern. This study was conducted in Surksha Hospital, Biratnagar, among suspected UTI patients from January to June 2021. Altogether, 400 urine samples were analyzed by the semi-quantitative culture method and uropathogens were identified by conventional methods. A total of 109 E. coli were tested for antimicrobial susceptibility by the Kirby Bauer disc diffusion method as per CLSI (Clinical and Laboratory Standards Institute) guidelines. Out of 400 samples, 48.75% gave significant growth while 25.5% shows no growth, 24.5 % shows non-significant growth and 1.5 % shows mixed growth. The distribution of UTI is the most common among the age group 16-49 years. E. coli was found to be the most predominant isolate (55.5%) followed by Coagulase-negative Staphylococci (CoNS) (12.8%) and Enterococcus fecalis (4.1%). Nitrofurantoin was found to be the most effective antibiotic followed by ciprofloxacin and ofloxacin while cephalexin was the least effective. Out of 109 E. coli isolates, 90.8% were MDR strains. E. coli showed a higher rate of resistance toward commonly used oral antibiotics. However, nitrofurantoin is still active against E. coli. Thus, nitrofurantoin could be the choice for empirical therapy of UTIs.