Fluoroquinolone Resistant Escherichia Coli and Klebsiella Spp. in Community-Acquired Urinary Tract Infections in Rural Kanpur, India 978-981
Dr. Devjyoti Majumdar,
Professor, Department of Microbiology,
Rama Medical College Hospital and Research Center
Mandhana GT Road Kanpur- 209217 UP, India.
Introduction: In the community, most of the patients are treated by the local physicians with empirically chosen antimicrobials, without any laboratory confirmation. The aim of the present study was to determine the aetiology and the antimicrobial susceptibility of the uropathogens in culture-positive, community-acquired urinary tract infections in the rural areas around Mandhana, Kanpur, over a period of 14 months.
Materials and Methods: The patients who presented with the symptoms of Urinary Tract Infection (UTI) were included in this study. The samples were inoculated in the camp on MacConkey’s agar (MAC) and Sheep Blood Agar (SBA). The incubation, identification and the Antimicrobial Susceptibility Tests (AST) for the organisms which were done in the hospital laboratory.
Results: The most common bacteria which were isolated in all the age and gender groups were Escherichia coli (54%) and Klebsiella spp (11.3%). Among the oral antimicrobials which were usually prescribed by the local physicians in Kanpur, lomefloxacin, amoxicillin/sulbactum and nitrofurantoin were the ones to which the Enterobacteriaceae family was the most susceptible to. The resistance rate of Klebsiella to most of the antimicrobials was high (>20%). The resistance to the antimicrobials did not vary significantly with age, sex or any demographic factors.
Conclusion: The empirical treatment of the Community Acquired Urinary Tract Infections (CAUTIs) in the rural areas of Kanpur with co-trimoxazole, chloramphenicol, ciprofloxacin or norfloxacin is inadequate. Amoxicillin/sulbactum, nitrofurantoin or lomefloxacin should be the drugs of choice.