Community- Acquired Urinary Tract Infection: A Study on Responsible Bacteria with their Antibiotic Susceptibility Pattern in Kolkata, India

Introduction: Community-acquired urinary tract infection (CAUTI) is considered to be a common cause for seeking medical care. Since there is a common practice to treat CAUTI empirically before the availability of urine culture sensitivity report, it requires knowledge on the prevailing antibiotic sensitivity pattern of the uropathogens in that region. Objective: The present study was conducted to determine the distribution and antimicrobial sensitivity pattern of bacterial uropathogens isolated from the patients with CAUTIs in an attempt to help authorities to formulate antibiotic prescription policies. Materials and Methods: Aseptically collected midstream urine samples from symptomatic UTI patients attending Outpatient Department of this tertiary care hospital were subjected to microbiological analysis. After semi quantitative culture, the responsible bacteria with significant colony count were identified by biochemical tests and Vitek 2 automated system. Antimicrobial susceptibility testing of the isolated uropathogens was performed by modified Kirby Bauer's disc diffusion method in accordance with the recommendations of the Clinical and Laboratory Standards Institute. Result: Of the 269 isolated uropathogens, Escherichia coli was found to be the predominant one comprising 50.93% of the total isolates followed by Klebsiella pneumoniae (20.07%) and Enterococcus faecalis (14.13%). The isolated E. coli were highly sensitive to gentamicin (90.51%), nitrofurantoin (87.59%), imipenem (87.59%), and piperacillin-tazobactum (85.4%). However, only 58.39% and 49.64% of isolated E. coli were sensitive to ciprofloxacin and cotrimoxazole, respectively. Regarding Grampositive cocci, a high potency of nitrofurantoin, vancomycin, and linezolid against them was observed. Conclusion: The isolated uropathogens exhibited higher resistance to commonly used oral antibiotics such as ciprofloxacin, cotrimoxazole, amoxicillin-clavulanate, and cefazolin. Since they exhibited high-level sensitivity to oral antibiotic nitrofurantoin apart from parenterally used antibiotics, use of nitrofurantoin can be emphasized as a first line treatment option for treating the patients suffering from CAUTI in this region.