PREVALENCE AND IDENTIFICATION OF UROPATHOGENS IN EASTERN NEPAL AND UNDERSTANDING THEIR ANTIBIOGRAM DUE TO MULTIDRUG RESISTANCE AND ESBL

This study was basically aimed at identifying the diversity of uropathogens; their drug response like multi-drug resistance (MDR) or extended spectrum β-lactamase (ESBL); and the evaluation of empirical treatment. Between January 2016 and December 2016, urine samples from patients of Koshi Zonal Hospital, Biratnagar, were collected in this cross-sectional descriptive study. Of 3666 urine samples, 414 (11.3%) samples were found to be positive with significant bacteriuria. 70.53% of prevalence was seen in female and 29.47% was in the male. Most common bacteria were E. coli (67.87%) followed by Klebsiella (14.01%) and Pseudomonas (13.77%) respectively. Of the total 281 E. coli positive isolates, 111 (39.5%) were found to be MDR while 64 (22.8%) were identified as ESBLs. Out of total 57 Pseudomonas, 63.16% were MDR and 5.25% were ESBLs. Of 58 Klebsiella samples, 56.9% were accounted as MDR and 6.9% as ESBLs. Isolates were mostly susceptible to amikacin, nitrofurantoin, and levofloxacin, but, were highly resistant to ampicillin, cefexime, and cefotaxime. Multiple antibiotic resistance (MAR) indices of bacteria indicated an alarming scenario of drug resistance. The increasing resistance to several classes of drugs and the extended spectrum is increasingly making empirical treatment ineffective ultimately leading to a high cost of treatment.