Prevalence of Urinary Tract Infections, their Bacterial Etiology and Antibiogram - A Study Kiran Ghimire, Baral B., Karna S., Baral M.P. PhD B. P. Koirala Institute Of Health Sciences Dharan, Nepal.

INTRODUCTION Urinary tract infection is any type of urothelial inflammatory response resulting from microbial invasion of the urinary tract defined microbiologically as the detection of both bacteriuria 105 CFU/ml and pyuria >10 leucocytes/HPF (Astal et al., 2002) It represents one of the most common diseases encountered in medical practice today and occurring from the neonates to the geriatric age group Symptomatic UTI are either uncomplicated or complicated.

BACKGROUND Common pathogens causing UTI are Gram negative Bacteria: Escherichia coli, Klebsiella spp., Proteus mirabilis, Proteus vulgaris, Enterobacter spp. Gram positive Bacteria Staphylococcus aureus, Staphylococcus saprophyticus, Enterococcus faecalis, Group B streptococci. Other pathogens: Chlamydia trachomatis, Mycoplasma (Ureaplasma urealyticum), Candida spp

Qq BACKGROUND UTI is common in women, uncommon in men. Recurrent infection causes considerable morbidity; if complicated, it can cause severe renal diseases including end-stage renal failure. It is also a common source of life threating Gram-negative septicemia (Kumar and Clark, 2002).

RATIONALE Antibiotics in the treatment of UTI are usually given empirically without proper antibiotic susceptibility testing in Nepal. This is one of the major causes for the development of multi-drug resistant (MDR) urinary pathogens. To ensure appropriate and specific therapy, current knowledge of the microorganisms that cause UTI and their antibiotic susceptibility is mandatory.

OBJECTIVES To determine the prevalence of UTI among different patients attending a healthcare center in Kathmandu, Nepal. To isolate and identify the etiological agent from urine sample. To determine the antibiotic susceptibility pattern of the isolates.

Materials & Methods Study design: Comparative, Cross – Sectional Study Study Area: Kathmandu Hospital, Kathmandu, Nepal Sample Size: 521 Study period: 6 months

Materials & Methods (contd….)   We collected mid-stream urine samples from 521 different patients from both out-patient and in-patient departments. The patients were properly instructed and a sterile, dry, wide-necked leak-proof container was given to them and requested for 10-20ml mid-stream urine sample. The urine samples were processed and assessed in microbiology laboratory. Then antibiotic susceptibility test was performed to identify the prevalence of drug resistant bacteria among the isolates.

The primary results are depicted in the following pictures:

Fig:1 significant growth among sAMPLES

FIG : 2 Organisms isolated

FIG:3 PREVALENCE OF MDR ORGANISMS 34.1%

MDR ISOLATES

CONCLUSION There is an increasing trend in the incidence of UTIs Because of the increasing drug resistance which is in turn caused by prescribing antibiotics inadvertently without proper susceptibility testing. So proper identification of the pathogens before commencing therapy in case of UTIs and rational use of antimicrobials is mandatory to control this emerging problem.

ACKNOWLEDGEMENTS I WOULD LIKE TO THANK THE FOLLOWING PEOPLE WITHOUT WHOSE LOVE AND SUPPORT THIS WOULD NOT HAVE BEEN POSSIBLE: MY SUPERVISOR: DR. MADHAV P BARAL MY CO- RESEARCHERS: B. BARAL, S. KARNA MY FAMILY FOR THEIR SUPPORT AND BLESSINGS

THANK YOU FOR YOUR ATTENTION