Antimicrobial susceptibility pattern of uropathogens in urinary tract infections (UTI) patients of Punjab, Pakistan
Keywords:
antibiogram panel, resistant pattern, CLSI panel, Enterobacteriaceae, hospital, urine tract infectionAbstract
The prevalence, antimicrobial susceptibility pattern, and associated factors of urinary tract infections among Punjabi patients attending Tertiary Care Hospitals of Punjab were the objectives of this study. Participants were selected by systematic random sampling in a cross-sectional study at Tertiary Care Hospitals of Punjab. 988 participants provided clean catch midstream urine samples, which were then cultured and tested for antimicrobial susceptibility. We inoculated n=988 urine samples in which 255 samples were found positive for bacterial growth. Among them 126 were E. coli, 66 Klebsiella pneumoniae, 4 Enterobacter cloacae, and 21 were Pseudomonas spp. The frequency of Uropathogens was observed for Gram negative E. coli 49.02% and Gram positive bacteria were 7.78%. The prevalence of urinary tract infections was 16.4%. Pseudomonas aeruginosa (19, 7.3%), Pseudomonas spp. (2, 0.7%), Enterobacter cloacae (4, 1.5%), and Gram positive bacteria such as Methicillin resistant staphylococcus aureus (3, 1.1%), Methicillin sensitive staphylococcus aureus (15, 5.8%), and Enterococcus faecalis (20, 7.7%) were the most common bacteria. Ampicillin and tetracycline were both resistant to Gram-negative bacilli (96%) and Gram-positive cocci (72%), respectively. In the study area, a culture and susceptibility test is essential for effective urinary tract infection management.
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Abbasi, S.K., A.R. Abbasi, S.A. Khan, F. khan Abbasi, Z.A. Qureshi, and A. Zainub. 2018. Antimicrobial Susceptibility Patterns of Leading Uropathogens and an Empirical Therapy at a Tertiary Care Hospital, Muzaffarabad. life. 6:8.
Abdallah, I., and M. Abdulla. 2009. Antibiotic resistance in Pseudomonas aeruginosa isolated from various clinical specimens in Ibn e Sina Hospital-Sirte-Libya. Bull Alex Fac Med. 45:771-775.
Agarwal, K., M. Harathi, P.H.P.K. PayalaVijayalakshmi, K. Gandhi, and S.P. Rao. 2020. Bacteriological Profile and Antibiotic Susceptibility Profile of Emerging Gram-positive Uropathogens in Tertiary Care Centre, Visakhapatnam, India. Journal of Critical Reviews. 7:3590-3597.
Agarwal, M., L. Gupta, and K. Bala. 2015. Identification and antibiotic susceptibility testing of urinary isolates in a tertiary care hospital. Der Pharmacia Lettre. 7:270-279.
Ahmed, N., B. Zeshan, M. Naveed, M. Afzal, and M. Mohamed. 2019. Antibiotic resistance profile in relation to virulence genes fimH, hlyA and usp of uropathogenic E. coli isolates in Lahore, Pakistan. Trop. Biomed. 36:559-568.
Ahmed, N., H. Khalid, M. Mushtaq, S. Basha, A.A. Rabaan, M. Garout, M.A. Halwani, A. Al Mutair, S. Alhumaid, and Z. Al Alawi. 2022c. The Molecular Characterization of Virulence Determinants and Antibiotic Resistance Patterns in Human Bacterial Uropathogens. Antibiotics. 11:516.
Ahmed, N., K. Tahir, S. Aslam, S.M. Cheema, A.A. Rabaan, S.A. Turkistani, M. Garout, M.A. Halwani, M. Aljeldah, and B.R. Al Shammari. 2022e. Heavy Metal (Arsenic) Induced Antibiotic Resistance among Extended-Spectrum β-Lactamase (ESBL) Producing Bacteria of Nosocomial Origin. Pharmaceuticals. 15:1426.
Ahmed, N., M. Khan, W. Saleem, M. Karobari, R. Mohamed, A. Heboyan, A. Rabaan, A. Mutair, S. Alhumaid, and S. Alsadiq. 2022d. Evaluation of Bi-Lateral Co-Infections and Antibiotic Resistance Rates among COVID-19 Patients. Antibiotics 276.
Ahmed, N., M.I. Karobari, A. Yousaf, R.N. Mohamed, S. Arshad, S.N. Basheer, S.W. Peeran, T.Y. Noorani, A.A. Assiry, and A.S. Alharbi. 2022b. The Antimicrobial Efficacy Against Selective Oral Microbes, Antioxidant Activity and Preliminary Phytochemical Screening of Zingiber officinale. Infection and Drug Resistance. 15:2773.
Ahmed, N., S. Habib, M. Muzzammil, A.A. Rabaan, S.A. Turkistani, M. Garout, M.A. Halwani, M. Aljeldah, B.R. Al Shammari, and A.A. Sabour. 2022a. Prevalence of Bacterial Pathogens among Symptomatic–SARS-CoV-2 PCR-Negative Patients. Microorganisms. 10:1978.
Ahmed, N., Z. Ali, M. Riaz, B. Zeshan, J.I. Wattoo, and M.N. Aslam. 2020. Evaluation of antibiotic resistance and virulence genes among clinical isolates of Pseudomonas aeruginosa from cancer patients. Asian Pacific journal of cancer prevention: APJCP. 21:1333.
Andrade, S.S., R.N. Jones, A.C. Gales, and H.S. Sader. 2003. Increasing prevalence of antimicrobial resistance among Pseudomonas aeruginosa isolates in Latin American medical centres: 5 year report of the SENTRY Antimicrobial Surveillance Program (1997–2001). Journal of Antimicrobial Chemotherapy. 52:140-141.
Basu, S., and M. Mukherjee. 2018. Incidence and risk of co-transmission of plasmid mediated quinolone resistance and extended spectrum β-lactamase genes in fluoroquinolone resistant uropathogenic E. coli: a first study from Kolkata, India. Journal of global antimicrobial resistance.
Boroumand, M.A., M.S. Anvari, and E. Habibi. 2012. Detection of vim-and ipm-type metallo-beta-lactamases in Pseudomonas aeruginosa clinical isolates. Archives of Iranian medicine. 15:670.
Brink, A.J., J. Coetzee, C.G. Clay, S. Sithole, G.A. Richards, L. Poirel, and P. Nordmann. 2011. Emergence of New Delhi metallo-beta-lactamase (NDM-1) and Klebsiella pneumoniae carbapenemase (KPC-2) in South Africa. Journal of clinical microbiology:JCM. 05956-05911.
Capparelli, E., C. Hochwald, M. Rasmussen, A. Parham, J. Bradley, and F. Moya. 2005. Population pharmacokinetics of cefepime in the neonate. Antimicrobial agents and chemotherapy. 49:2760-2766.
Chouchani, C., R. Marrakchi, I. Henriques, and A. Correia. 2013. Occurrence of IMP-8, IMP-10, and IMP-13 metallo-β-lactamases located on class 1 integrons and other extended-spectrum β-lactamases in bacterial isolates from Tunisian rivers. Scandinavian journal of infectious diseases. 45:95-103.
Colgan, R., L.E. Nicolle, A. McGlone, and T.M. Hooton. 2006. Asymptomatic bacteriuria in adults. American family physician. 74:985-990.
Dubey, D., F.S. Raza, A. Sawhney, and A. Pandey. 2013. Klebsiella pneumoniae renal abscess syndrome: a rare case with metastatic involvement of lungs, eye, and brain. Case reports in infectious diseases. 2013.
Esposito, S., G. Maglietta, M.D. Costanzo, M. Ceccoli, G. Vergine, C.L. Scola, C. Malaventura, A. Falcioni, A. Iacono, and A. Crisafi. 2021. Retrospective 8-Year Study on the Antibiotic Resistance of Uropathogens in Children Hospitalised for Urinary Tract Infection in the Emilia-Romagna Region, Italy. Antibiotics. 10:1207.
Garau, J., and L. Gomez. 2003. Pseudomonas aeruginosa pneumonia. Current opinion in infectious diseases. 16:135-143.
Hussain, S., B. Zeshan, R. Arshad, S. Kabir, and N. Ahmed. 2022. MRSA Clinical Isolates Harboring mecC Gene Imply Zoonotic Transmission to Humans and Colonization by Biofilm Formation. Pakistan J. Zool.
Maheen, S., Z. Mahmood, and A.N. Bhatti. 2014. Midstream urine isolates: Sensitivity pattern of various antibiotics in pediatric patients. The Professional Medical Journal. 21:320-324.
Mehboob, M., M. Hakim, O. Ullah, S.S. Lodhi, M. Anees, I. Khalil, and M.N. Shuja. 2021. Identification and Characterization of Urinary Tract Infectious Bacteria and its Antibiotic Sensitivity. BioScientific Review. 3:43-62.
Mustafai, M.M., M. Hafeez, S. Munawar, S. Basha, A.A. Rabaan, M.A. Halwani, A. Alawfi, A. Alshengeti, M.A. Najim, and S. Alwarthan. 2023. Prevalence of Carbapenemase and Extended-Spectrum β-Lactamase Producing Enterobacteriaceae: A Cross-Sectional Study. Antibiotics. 12:148.
Najeeb, S., T. Munir, S. Rehman, A. Hafiz, M. Gilani, and M. Latif. 2015. Comparison of urine dipstick test with conventional urine culture in diagnosis of urinary tract infection. J Coll Physicians Surg Pak. 25:108-110.
Naveed, M., J.-u. Hassan, M. Ahmad, N. Naeem, M.S. Mughal, A.A. Rabaan, M. Aljeldah, B.R.A. Shammari, M. Alissa, and A.A. Sabour. 2022a. Designing mRNA-and Peptide-Based Vaccine Construct against Emerging Multidrug-Resistant Citrobacter freundii: A Computational-Based Subtractive Proteomics Approach. Medicina. 58:1356.
Naveed, M., K. Jabeen, R. Naz, M.S. Mughal, A.A. Rabaan, M.A. Bakhrebah, F.M. Alhoshani, M. Aljeldah, B.R.A. Shammari, and M. Alissa. 2022b. Regulation of Host Immune Response against Enterobacter cloacae Proteins via Computational mRNA Vaccine Design through Transcriptional Modification. Microorganisms. 10:1621.
Parveen, S., S. Saqib, A. Ahmed, A. Shahzad, and N. Ahmed. 2020. Prevalence of MRSA colonization among healthcare-workers and effectiveness of decolonization regimen in ICU of a Tertiary care Hospital, Lahore, Pakistan. Advancements in Life Sciences. 8:38-41.
Rabaan, A.A., K. Eljaaly, S. Alhumaid, H. Albayat, W. Al-Adsani, A.A. Sabour, M.A. Alshiekheid, J.M. Al-Jishi, F. Khamis, and S. Alwarthan. 2022b. An Overview on Phenotypic and Genotypic Characterisation of Carbapenem-Resistant Enterobacterales. Medicina. 58:1675.
Rabaan, A.A., S. Alhumaid, A.A. Mutair, M. Garout, Y. Abulhamayel, M.A. Halwani, J.H. Alestad, A.A. Bshabshe, T. Sulaiman, and M.K. AlFonaisan. 2022a. Application of Artificial Intelligence in Combating High Antimicrobial Resistance Rates. Antibiotics. 11:784.
Ramzan, M., M.I. Karobari, A. Heboyan, R.N. Mohamed, M. Mustafa, S.N. Basheer, V. Desai, S. Batool, N. Ahmed, and B. Zeshan. 2022. Synthesis of silver nanoparticles from extracts of wild ginger (Zingiber zerumbet) with antibacterial activity against selective multidrug resistant oral bacteria. Molecules. 27:2007.
Ranjan, K.P., N. Ranjan, S.K. Bansal, and D. Arora. 2010. Prevalence of Pseudomonas aeruginosa in post-operative wound infection in a referral hospital in Haryana, India. Journal of laboratory physicians. 2:74.
Rasool, Z., H. Noreen, A. Anjum, A. Rizvi, A.A. Rabaan, M.A. Halwani, A.A. Sabour, M. Aljeldah, B.R.A. Shammari, and S.M. Alhajri. 2022. Genotypic and Phenotypic Characterization of Erythromycin-Resistant Staphylococcus aureus Isolated from Bovine Mastitis and Humans in Close Contact. Tropical Medicine and Infectious Disease. 8:26.
Rizvi, A., M.U. Saeed, A. Nadeem, A. Yaqoob, A.A. Rabaan, M.A. Bakhrebah, A. Al Mutair, S. Alhumaid, M. Aljeldah, and B.R. Al Shammari. 2022. Evaluation of Bi-Lateral Co-Infections and Antibiotic Resistance Rates among COVID-19 Patients in Lahore, Pakistan. Medicina. 58:904.
Shakil, S., R. Khan, R. Zarrilli, and A.U. Khan. 2008. Aminoglycosides versus bacteria–a description of the action, resistance mechanism, and nosocomial battleground. Journal of biomedical science. 15:5-14.
Sohail, M., M. Muzzammil, M. Ahmad, S. Rehman, M. Garout, T.M. Khojah, K.M. Al-Eisa, S.A. Breagesh, R.M.A. Hamdan, and H.I. Alibrahim. 2023. Molecular Characterization of Community-and Hospital-Acquired Methicillin-Resistant Staphylococcus aureus Isolates during COVID-19 Pandemic. Antibiotics. 12:157.
Struelens, M., D. Monnet, A. Magiorakos, F.S. O’Connor, and J. Giesecke. 2010. New Delhi metallo-beta-lactamase 1-producing Enterobacteriaceae: emergence and response in Europe. Eurosurveillance.
Tam, V.H., K.-T. Chang, K. Abdelraouf, C.G. Brioso, M. Ameka, L.A. McCaskey, J.S. Weston, J.-P. Caeiro, and K.W. Garey. 2010. Prevalence, resistance mechanisms, and susceptibility of multidrug-resistant bloodstream isolates of Pseudomonas aeruginosa. Antimicrobial agents and chemotherapy. 54:1160-1164.
Tariq, F., N. Ahmed, M. Afzal, M.A.U. Khan, and B. Zeshan. 2020. Synthesis, Characterization and antimicrobial activity of Bacillus subtilis-derived silver nanoparticles against multidrug-resistant bacteria. Jundishapur Journal of Microbiology. 13.
Vieira, G., N. Leal, A. Rodrigues, C. Chaves, F. Rodrigues, and N. Osório. 2020. MRSA/MSSA causing infections: prevalence of mecA gene. European Journal of Public Health. 30:ckaa040. 052.
Yusof, N.Y., N.I.I. Norazzman, S.N.a.W.A. Hakim, M.M. Azlan, A.A. Anthony, F.H. Mustafa, N. Ahmed, A.A. Rabaan, S.A. Almuthree, and A. Alawfi. 2022. Prevalence of Mutated Colistin-Resistant Klebsiella pneumoniae: A Systematic Review and Meta-Analysis. Tropical Medicine and Infectious Disease. 7:414.
Zahra, N., B. Zeshan, M.M.A. Qadri, M. Ishaq, M. Afzal, and N. Ahmed. 2021. Phenotypic and genotypic evaluation of antibiotic resistance of Acinetobacter baumannii bacteria isolated from surgical intensive care unit patients in Pakistan. Jundishapur Journal of Microbiology. 14.
Zeb, S., M. Mushtaq, M. Ahmad, W. Saleem, A.A. Rabaan, B.S.Z. Naqvi, M. Garout, M. Aljeldah, B.R. Al Shammari, and N.J. Al Faraj. 2022. Self-Medication as an Important Risk Factor for Antibiotic Resistance: A Multi-Institutional Survey among Students. Antibiotics. 11:842.
Zeshan, B., M.I. Karobari, N. Afzal, A. Siddiq, S. Basha, S.N. Basheer, S.W. Peeran, M. Mustafa, N.H.A. Daud, and N. Ahmed. 2021. The usage of antibiotics by COVID-19 patients with comorbidities: the risk of increased antimicrobial resistance. Antibiotics. 11:35.
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