Publication: Prevalence and Antimicrobial Susceptibility of Multi-Drug Resistant Uropathogens in a Tertiary Hospital in Nepal: A One-Year Audit
Date
2025
Journal Title
Journal ISSN
Volume Title
Publisher
Nepal Medical Association
Abstract
Abstract
Introduction: Antibiotic resistance, especially multidrug resistance, poses a global public health threat. It complicates the treatment of infections like urinary tract infections, leading to treatment failure, extended hospital stays, and increased healthcare costs. Empirical antibiotic therapy, guided by local resistance patterns, is crucial for patient outcomes and infection prevention. This study analyzes urine cultures from TU-Teaching Hospital from January to December 2024 to investigate the prevalence and antimicrobial susceptibility of multidrug-resistant uropathogens.
Methods: This was a retrospective, observational hospital-based study conducted in a tertiary care center after obtaining the ethical approval from Institutional Review Committee (IRC), (Approval reference: 470 (6-11) E2). All samples tested fromJanuary 1, 2024, to December 31, 2024 the period included in the study. Data were collected from the Electronic health records of the Microbiology
department and analyzed using Microsoft Excel 16.0.0 and SPSS 30.0.0 software to determine the urine culture positivity rate, the prevalence of multidrug-resistant uropathogens, and their antimicrobial susceptibility patterns with a specific focus on resistance to commonly prescribed antibiotics.
Results: A total of 25,315 urine samples were collected for urine culture and sensitivity testing during the study period. Significant bacterial growth was seen in 4,557 (18%). Multidrug resistance was seen in 3,448 (75.66%). The most frequently isolated organisms were Escherichia coli 1724 (50%), Klebsiella 154 (17.7%). E. coli, Klebsiella, Enterococcus, Citrobacter, Pseudomonas, and Acinetobacter showed resistance to Ceftriaxone (74.61–92.20%), Amoxycillin+Clavulanate (67.58–97%), and Nitrofurantoin
(52.29–89.55%) across selectively tested isolates.
Conclusions: Urine samples demonstrated a high prevalence of multidrug resistance to routinely prescribed antibiotics, even among second-line parenterally administered antibiotics. Only costly third-line antibiotics exhibited low resistance.
Description
Manish Man Pradhan
y, Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal
Sangita Sharma
Tribhuvan University Teaching Hospital, Institute of Medicine, Maharajgunj, Kathmandu, Nepal
Sujeet Poudyal
Tribhuwan University Teaching Hospital,Maharajgunj, Nepal
Diwas Gnyawali
Tribhuwan University Teaching Hospital,Maharajgunj, Nepal
Suman Adhikari
Tribhuwan University Teaching Hospital,Maharajgunj, Nepal
Suman Chapagain
Tribhuwan University Teaching Hospital,Maharajgunj, Nepal
Bhojraj Luitel
Tribhuwan University Teaching Hospital,Maharajgunj, Nepal
Hari Prasad Kattel
Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal
Pawan Raj Chalise
Tribhuwan University Teaching Hospital,Maharajgunj, Nepal