Diversity of uropathogens and their resistogram in diabetic and non-diabetic patients in sub Himalayan region of Uttarakhand, India: A case control study

Abstract

Background: Both symptomatic and asymptomatic urinary tract infections (UTIs) are thought to occur more frequently in diabetic patients. Local data about the antimicrobial resistance of Uropathogens should be available for proper therapeutic interventions of UTI. Objective: To evaluate the spectrum of the Uropathogens and their profiles of antimicrobial resistance on a series of diabetic and non-diabetic patients. Materials and Methods: A Case-Control study with 100 participants was conducted targeting the Diabetic and Non-diabetic population, symptomatic or asymptomatic for UTI. Antibiotic sensitivity test was done on each of the isolates and the results of the antibiogram were compared with that of control group (nondiabetic group). The statistical analysis was done by Chi-Square Test, Fisher exact test using statistical product and service solutions formerly known as Statistical Package for the Social Sciences (SPSS) 16.0 Version. Results: Most common isolate responsible for UTI was Escherichia coli followed by Klebsiella, Enterobacter, Proteus, Citrobacter, Acinetobacter and Candida. 93.3% and 86.6% of the isolates were sensitive to Amikacin and Amoxycillin-clavulanic acid respectively for Non Diabetics. Whereas isolates from diabetic group were 77.7 and 50% sensitive to Amikacin and Amoxycillin-clavulanic acid respectively. Highest resistance was seen for Cefuroxime for the isolates from both diabetic and non-diabetic group with 53.3 and 72.2% respectively. Significant difference in resistance pattern was observed in Amoxycillin-clavulanic acid, cefazolin, piperacillin-tazobactam and ticarcillin-clavulanic acid. Conclusion: Culture of urine and susceptibility testing of isolated organisms is strongly advocated in the clinical management of impending complication in diabetic individuals.