Bacteriological Profile and Drug Susceptibility Pattern of Uropathogens among the Patients Admitted in Intensive Care Units of a Tertiary Care Hospital in South Bihar

Introduction: Antimicrobial resistance is a major emerging world-wide problem in the intensive care unit (ICUs). Different types of uropathogenic organism causes infection and these organisms are developing resistance due to unnecessary usage of common antimicrobial agents which indicates strong necessity of detailed study on this public health problem for designing the appropriate Antimicrobial Policy as a global Antimicrobial Stewardship Programme. Material and Methods: This prospective laboratory based study was carried out in Department of Microbiology, NMCH, and Sasaram from Dec. 2022 to Nov. 2023. Total 273 urine samples from patients admitted in ICUs were tested following the CLSI guidelines (2023). Antimicrobial Susceptibility pattern of isolates were determined employing Kirby-Bauer Disk-diffusion method. Results: This study revealed 59(21.6%) culture positive bacterial isolates in 273 samples comprising of 18(30.5%) Gram-positive cocci and 41(69.4%) Gram-negative bacilli. Gram-negative bacteria were Escherichia coli 15(25.4%), Pseudomonas aeruginosa 11(18.6%), Citrobacter species 08(13.5%), Klebsiella pneumoniae 05(8.4%) and 2(3.3%) Acinetobacter baumannii. Gram-positive isolates were Enterococci species 11(18.6%) and Staphylococcus aureus 07(11.8%). Gram-positive isolates were sensitive to Nitrofurantoin (83.3%), Piperacillin-tazobactam (85.7%) with 88.8% sensitivity to Vancomycin and 100% to Linezolid. Gram-negative isolates were sensitive to Meropenem (58.5%), Nitrofurantoin (68.2%), and Fosfomycin (82.9%) with 100% sensitivity to Polymyxin B. This study showed resistance to Ampicillin (72.7%) and Ciprofloxacin (83.4%) for Gram-positive isolates and resistant to Ampicillin (93.3%), Ofloxacin (86.6%), Ceftriaxone (83.3%), Cefotaxime (83.3%) and Ciprofloxacin (82.9%) among Gram-negative isolates. Conclusion: This study showed prevalence of 21.6% uropathogens among ICU patients with Gram-negative bacteria 41(69.4%) and Gram-positive bacteria 18(30.5%) infection respectively with maximum sensitivity to Vancomycin, Linezolid and Polymyxin B. Study demonstrated multidrug resistance to Ampicillin, Ciprofloxacin, Ceftriaxone and Cefotaxime which is considered as a great concern of emergence of antibiotic resistance in this rural health setup.