The prevelance of multidrug resistance in uropathogens of patients admitted in the intensive care unit of a tertiary care hospital

Shaista Ahmed; Neetu Shree; Ajit Singh Narula; Purushottam Kr Nirala; Haya Majid; Aakriti Garg; Uzma Nayeem; Mohd Ashif Khan

doi:10.1007/s00210-024-03108-5

The prevelance of multidrug resistance in uropathogens of patients admitted in the intensive care unit of a tertiary care hospital

Naunyn Schmiedebergs Arch Pharmacol. 2024 Apr 21. doi: 10.1007/s00210-024-03108-5. Online ahead of print.

Authors

Shaista Ahmed¹, Neetu Shree², Ajit Singh Narula³, Purushottam Kr Nirala³, Haya Majid¹, Aakriti Garg^{1

4}, Uzma Nayeem¹, Mohd Ashif Khan⁵

Affiliations

¹ Department of Translational and Clinical Research, School of Chemical and Life Science, Jamia Hamdard, New Delhi, 110062, India.
² Department of Microbiology, Hamdard Institute of Medical Sciences & Research, New Delhi, 110062, India.
³ Department of Nephrology, Fortis Escort Heart Institute and Research Centre, New Delhi, 110025, India.
⁴ Department of Pharmacology, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, 110062, India.
⁵ Department of Translational and Clinical Research, School of Chemical and Life Science, Jamia Hamdard, New Delhi, 110062, India. makhan@jamiahamdard.ac.in.

PMID: 38643454
DOI: 10.1007/s00210-024-03108-5

Abstract

Urinary tract infections (UTIs) are among the most common bacterial infections, posing significant public health challenges due to increasing antimicrobial resistance (AMR). This study aims to assess the prevalence, demographic characteristics, microbial profile, and antimicrobial resistance patterns in Indian patients with UTIs admitted to intensive care unit. A total of 154 patients with positive UTIs were included in this cross-sectional study. The prevalence data including demographics, microbial isolates, and antimicrobial susceptibility patterns were collected. Additionally, risk factors for multidrug resistance uropathogens were assessed using multivariate analyses. The patient cohort had diverse demographic, with a slight male predominance of 52.6% (n = 81). The most common comorbidities were hypertension 59.1% (n = 91) and diabetes mellitus 54.5% (n = 84). The microbial profile was dominated by gram-negative bacteria, particularly Escherichia coli 26.62% (n = 41) and Klebsiella pneumoniae 17.53% (n = 27). The predominant gram-positive and fungal isolate was Enterococcus faecium 7.14% (n = 11) and Candida spp. 18.83% (n = 29), respectively. Substantial resistance was noted against common antimicrobials, with variations across different pathogens. Gram-negative bacteria, particularly Escherichia coli and Klebsiella pneumoniae, exhibited high MDR rates, emphasizing the challenge of antimicrobial resistance. Multivariate logistic regression identified age groups 50-65 and over 65, and prolonged catheterization as significant risk factors for MDR infections. A significantly high resistance rate among pathogens emphasizes the need for judicious antimicrobial use. Our findings emphasize the necessity of ongoing surveillance and tailored interventions based on local pathogen prevalence and antibiogram data to effectively address the threat of AMR threat for better management of UTI management in ICU settings.

Keywords: Intensive care unit; Multidrug resistance; Tertiary care hospital; Urinary tract infection; Uropathogens.