Antibacterial Resistance Trend in Urinary Tract Infections and Their Control at a Tertiary Care Hospital in the Saurashtra Region of Gujarat, India

Abstract

Urinary tract infections are a major infection burden globally and antimicrobial resistance can lead to treatment failures as well as upsurge cost of healthcare. The study was aimed to know the common pathogens responsible for urinary tract infection, their antibiotic resistance pattern, and bundle care effectiveness. 2352 urine samples were studied from the year 2013 to 2017. Urine culture and antibiotic sensitivity testing were carried out. Care bundle compliance for catheter-associated urinary tract infections (CAUTI) was observed during the starting year (2013) and end year (2017). 46.3% of samples found positive for the presence of significant bacteriuria. Escherichia coli was the commonest isolate followed by Pseudomonas aeruginosa and Klebsiella pneumoniae. All antibiotics found more or less resistant against various organisms, most trusted antibiotics against UTI, Nitrofurantoin found 20.8% (CI = 18.0-23.8) resistant overall. Out of all E. coli isolated,86.0% were possible extended-spectrum beta-lactamase (ESBL) producers, 18.3% were carbapenem-resistant, 20.7% were amikacin resistant and 0.7% were colistin-resistant.The number of CAUTIand CAUTI rates per 1000 catheter days decreased where, p = 0.0482 and p = 0.0783 respectively.CAUTI bundle shows no significant difference;p = 0.8475.Non-bias compliance surveys and continuous monitoring with quality care can limit nosocomial infections