DIAGNOSTIC EVALUATION OF NORFLOXACIN, FOSFOMYCIN AND NITROFURANTOIN IN URINARY ISOLATES CAUSING UTI

Abstract

Objective: Comparative evaluation of Norfloxacin, Fosfomycin and Nitrofurantoin in urinary isolates causing UTI

Material and Methods: It was Comparative Cross-sectional study. It was conducted at Department of Pathology at THQ hospital Pindigheb. The study was completed (including data compilation & analysis) in 1 year period from 28 Aug 2021 to 27 Aug 2022. Two hundred and seventy-five urinary isolates   from urine specimens received for culture and sensitivity in the department of pathology at THQ hospital Pindigheb, were included in the study, as approved in the Internal Review Board. Non-probability consecutive sampling technique was used. Isolates were identified as urinary isolates by colonial morphology, Gram stain and biochemical tests. The zones of clearance around filter paper disc of Norfloxacin (10 µg), Fosfomycin (200µg) and Nitrofurantion (300µg) impregnated over lawn of bacterial isolate on Mueller-Hinton agar by Kirby-Bauer disc diffusion method as per Clinical and Laboratory Standard Institute (CLSI) guidelines were recorded.

Results: Out of total 275 samples 180(65.45%) samples yielded significant growth of Enterobacteriaceae. The females were 44.43% and males were 55.55% in in door and outdoor patient respectively.  0ut of 180 samples 100(55.55%) samples yielded growth of Escherichia coli followed by 50 (27.77%) were klebsiella pneumoniae and 30 (16.67%) were Enterobacter spp. The sensitivity pattern of Escherichia coli was noted to norfloxacin, Fosfomycin and nitrofurantoin {(50%,30%)},and {(6%, 2%)} resistance and sensitive respectively. klebsiella pneumonia and Enterobacter cloacae showed resistance and sensitive pattern {60%,10%)}(1), {(33.33%,16.67%)}, {(2%,10%)},{( 10%,6.7%)}and {(4%,2%)},{(13.33%,20%)} against norfloxacin, Fosfomycin and nitrofurantoin respectively.

Conclusion: Our study revealed high frequencies of norfloxacin, Fosfomycin and nitrofurantoin resistance among uropathogen at THQ hospital Pindigheb. A strong liaison between clinicians and microbiologists is recommended to keep abreast with the changes in antimicrobial susceptibility of uropathogens in order to suggest a suitable empiric therapy. Infection control measures are recommended, so that appropriate management can be instituted and spread of these resistant organisms curtailed.

Key Words: Norfloxacin resistance, Escherichia coli, Urinary tract infection. Urinary isolates, Fosfomycin