A Cross-Sectional Study on Spectrum of Bacteria Causing Urinary Tract Infections and Their Sensitivity Pattern in Patients with Lower Urinary Tract Symptoms at Akash Hospital

Lohith A H, Chethan R, Prajwal P, Chandan S, Vishwas T

Abstract: Lower urinary tract symptoms (LUTS) are identified as a broad group of conditions encompassing a wide range of specific discomforts and functional issues related to the bladder and urethra1. As previously discussed, these symptoms include frequency, nocturia, urgency, strangury, urge incontinence, stress incontinence, nocturnal enuresis, hesitancy, reduced urinary stream, intermittency, straining, incomplete emptying, hematuria, post-micturition dribble, and dysuria. While LUTS can arise from various causes, urinary tract infections (UTIs) are a significant contributor. The study in question is specifically designed to address critical aspects of UTIs that directly impact the effective management of these conditions. The primary objective of this research is to investigate the spectrum of bacteria responsible for causing urinary tract infections and to determine their sensitivity patterns. This means the study aims to identify which specific types of bacteria are commonly found in UTIs and, crucially, to understand how these bacteria respond to different antimicrobial treatments. Understanding the bacterial spectrum is vital because different bacteria may require different therapeutic approaches. Furthermore, determining their "sensitivity patterns" involves assessing their susceptibility or resistance to various antibiotics. This information is indispensable for clinicians, as it directly informs decisions regarding the most effective antibiotics to prescribe. By pinpointing the specific pathogens and their vulnerabilities, the study facilitates proper management of lower urinary tract infections1. The ultimate goal of this detailed investigation is to reduce the dangerous complications of lower urinary tract infections, ensuring that patients receive targeted and effective treatment to prevent more severe health issues. In essence, the research provides foundational data necessary for optimizing treatment strategies for UTIs and, by extension, mitigating the impact of related LUTS. Materials and Methods: A prospective observational study was conducted during April 2023- September 2024. All positive urine culture and sensitivity reports of males and females aged > 18 years were included, excluding the patients who were diagnosed with Upper Urinary Tract Infection and Patients with a Urinary Catheter in situ. A total of 91 patient samples were analyzed for bacterial isolates, demographic characteristics, and antibiotic sensitivity patterns. Descriptive statistics were used to summarize age distribution, gender distribution, and laboratory findings. Graphs and tables are incorporated to enhance the interpretation of results. Results: Out of 91 positive urine cultures, males were 34 (37.4%) and females were 57 (62.6%). E. coli (48.4 %) was the most common organism, followed by Klebsiella (16.5%), Proteus (11.0%), Citrobacter (7.7%), Pseudomonas aeruginosa (6.6%, Staphylococcus aureus (5.5%, Enterococci (4.4%). The prevalence of UTI in females was significantly higher than males. The most susceptible age group for UTI was 20-40years, followed by 60-70yrs.E coli and Klebsiella pneumoniae was sensitive to antibiotic Piperacillin, Tazobactam, Meropenem, Imipenem, Amikacin, Gentamycin, Nitrofurantoin and were resistant to ampicillin. Enterococcus was sensitive to vancomycin, linezolid, tigecycline. Staphylococcus was sensitive to vancomycin, linezolid, amikacin. The observed antibiotic resistance, particularly the 14.3% resistance to all antibiotics, raises concerns about multidrug-resistant (MDR) infections. The findings emphasize the need for regular antibiotic susceptibility testing to guide empirical therapy and reduce the emergence of resistance. The presence of intermediate sensitivity to cephalosporins and fluoroquinolones suggests a possible shift in resistance trends, necessitating careful selection of treatment protocols. Conclusion: In this study, females were mostly affected and the most common organisms were E. coli and Klebsiella. This study highlights the predominance of E. coli in UTIs and the concerning level of antibiotic resistance among isolates. These organisms were most sensitive to Piperacillin Tazobactam, Meropenem, Imipenem, Amikacin, gentamycin, nitrofurantoin and resistant predominantly to Ampicillin. The sensitivity and resistance pattern of uropathogens to common antimicrobial agents must be taken into account when selecting treatment plans for UTI. The findings underscore the importance of antibiotic stewardship programs and routine culture and sensitivity testing to optimize treatment outcomes.

Keywords: Antibiotic sensitivity, Antibiotic resistance, Antimicrobial Treatments, Bacterial Spectrum, Sensitivity Patterns, Multidrug resistance, Urinary tract infection, LUTS, Frequency, Nocturia, Urgency, Strangury, Urge Incontinence, Stress Incontinence, Nocturnal Enuresis, Hesitancy, Reduced Urinary Stream, Intermittency, Straining, Incomplete Emptying, Hematuria, Post-Micturition Dribble, Dysuria