URINARY TRACT INFECTION IN TERTIARY CARE HOSPITAL IN KERALA AND BURKHOLDERIA CEPACIA IN UNCOMPLICATED UTI

Abstract

Nizamuddin Mundangalam

BACKGROUND Burkholderia cepacia complex urinary infections are mostly reported in patients who had undergone procedures in hospital set up by contact with contaminated catheters or gel used for lubricating the catheter. Here with present isolation of Burkholderia cepacia complex in patients of uncomplicated UTI who did not have previous history of intervention in the urinary tract. MATERIALS AND METHODS For reviewing the anti-microbial profile of the urinary pathogen, study was conducted on 1000 consecutive urine samples received in Clinical Microbiology laboratory. Samples were collected from the patients who presented to the outpatient department and from those who were admitted. Samples received included routine antenatal screening urine samples and samples collected from patients undergoing elective surgical procedures. Sterile wide mouthed urine containers used for collection of mid-stream urine. RESULTS Out of 1000 urine samples studied, 192 pure isolates satisfying significant urinary pathogen. Antibiotic susceptibility of all the isolates documented with Whonet 5.6. No pathogen could be separately isolated in 165 samples which yielded mixed growth due to probable contamination with perineal flora by improper collection of the urine sample. Bacterial isolates obtained included Escherichia coli, Klebsiella sp. Enterococci and Pseudomonas isolated commonly in the order. Fungi isolated were predominantly non-albicans Candida species. CONCLUSION Antimicrobial surveillance plays a definite role in containment of resistant strains of bacteria causing urinary infections. Proper awareness among the health care providers regarding the spread of antibiotic resistance lead to rational prescription practices. Public awareness need to be emphasized through lay media about the unscrupulous self-medication which is contributing to resistance. The public needs to be re-assured about the nature of the condition that waiting for the antibiotic susceptibility study would not cause any excess signs and symptoms and damages.

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