Comparison of Anti-Microbial Susceptibility of Pseudomonas Aeruginosa Causing Community and Hospital Acquired Urinary Tract Infection at a Tertiary Care Hospital

Introduction: Urinary Tract Infections (UTIs) are a leading cause of morbidity in both community and healthcare settings, with Healthcare-Associated UTIs (HAUTIs) being the most prevalent healthcare-acquired infections. The emergence of multidrug-resistant pathogens, such as Pseudomonas aeruginosa, poses significant challenges to effective treatment. Objectives: This study investigates the prevalence of Pseudomonas aeruginosa in Community- Acquired (CA-UTI) and Hospital-Acquired (HA-UTI) urinary tract infections and evaluates their antimicrobial susceptibility profiles to guide therapeutic strategies. Materials and Methods: Urine samples were collected from outpatients (classified as CA-UTI) and discharged patients with urinary catheters within five days post-discharge (classified as HA-UTI). Uropathogens were isolated and Antimicrobial Susceptibility Testing (AST) was performed to assess resistance patterns. Statistical Analysis: Data were analyzed using descriptive statistics, including mean, median, frequency and standard deviation with statistical significance set at p<0.05. Results: Between April 2023 and March 2024, total of 4,590 urine cultures were analyzed, identifying Pseudomonas aeruginosa in 219 cases (163 CA-UTI, 56 HA-UTI). Susceptibility rates for CA-UTI isolates were: Cefepime (42.9%), Ciprofloxacin (31.9%), Imipenem (61.1%), Meropenem (65.6%), Netilmicin (45.3%), Norfloxacin (19.6%), Piperacillin (49.0%), Piperacillin-Tazobactam (65.0%), Ticarcillin (36.1%), Aztreonam (27.6%), Tobramycin (50.9%) and Amikacin (25.1%). HA-UTI isolates exhibited higher resistance, with susceptibility rates of Cefepime (53.5%), Ciprofloxacin (32.1%), Imipenem (61.5%), Meropenem (63.6%), Netilmicin (62.3%), Norfloxacin (28.5%), Piperacillin (48.2%), Piperacillin-Tazobactam (73.2%), Ticarcillin (37.5%), Aztreonam (32.1%), Tobramycin (67.8%) and Amikacin (37.0%). Conclusion: The study reveals a concerning rise in multidrug resistance among Pseudomonas aeruginosa isolates, particularly in CA-UTI, underscoring the need for targeted antimicrobial stewardship and infection control measures to address this growing public health challenge.