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CORRELATING ANTIBIOTIC CONSUMPTION RATE WITH ANTIMICROBIAL RESISTANCE PATTERN OF UROPATHOGENS IN THE LAGOS UNIVERSITY TEACHING HOSPITAL
Abstract
The study on correlating antibiotic consumption rate with Antimicrobial resistance pattern of uropathogens was carried out in the Lagos University Teaching Hospital from January to June 2006. Midstream urine samples of 1520 patients with suspected urinary tract infections (UTI) which were sent to the Microbiology Laboratory were processed. Cultured specimens with growth of pathogen greater than 10,000 colony forming units per milliliter of urine were biochemically identified using the Analytical profile index (API) test kits. Antibiotic susceptibility testing was done on all identified uropathogens and all Escherichia coli and Klebsiella pneumoniae resistant to the third generation cephalosporins were tested for the production of extended spectrum betalactamases (ESLBs). The antibiotic resistance pattern of the isolated pathogens was correlated with the antibiotic consumption pattern of patients in LUTH.
Two hundred and fifteen bacterial pathogens were isolated with
Escherichia
coli being the most prevalent (57.2%). Twenty percent were
Klebsiella
pneumoniae and 7.9% were
P s e u d o m o n a s a e r o gin o s a in that order of prevalence. Other gram negative and gram positive bacteria isolates constituted 14.9%. About 14% and 11.6% of Escherichia coli and Kl ebsiella pneumoniae isolates respectively were found to be producing extended spectrum betalactamase (ESBLs).
Majority of isolates were resistant to cotrimoxazole and amoxicillin
clavulanate. There was high sensitivity of the pathogens isolated to
nitrofurantoin, ceftazidime, cefotaxime and cefoxithin.
For all the antimicrobials, there was an increase in resistance which was preceded by an increase in antimicrobial consumption. This increasing trend of resistance of uropathogens to antimicrobials was more with the Quinolones (ciprofloxacin and ofloxacin), cotrmoxazole (trimethoprimsulphamethoxazole) and amoxicillin-clavulanate in the face of increased consumption of these drugs.
