Antimicrobial Susceptibility Trends in Uropathogens: A ۶-Year Retrospective Study from Kerala, India

Introduction: Antimicrobial resistance (AMR) among uropathogens is a critical global public health challenge, potentially exacerbated by the COVID-۱۹ pandemic. This study evaluates the pandemic’s impact on antimicrobial susceptibility trends among uropathogens at a tertiary care center in Kerala over six years (۲۰۱۸–۲۰۲۳). Methods: A retrospective analysis of ۴,۴۶۱ uropathogen isolates was conducted using data from laboratory records. Data were analyzed using IBM SPSS Statistics version ۲۰, with Chi-square tests for associations. Results: Escherichia coli was the predominant pathogen (۵۷.۴%), followed by Klebsiella pneumoniae (۱۴.۳%) and Enterococcus spp. (۶.۰%). Other common isolates included Pseudomonas aeruginosa (۴.۲%) and Acinetobacter baumannii (۳.۳%), and fungi (۶.۸%). E. coli susceptibility to ampicillin increased significantly from ۳.۴% in ۲۰۱۸ to ۱۳.۹% in ۲۰۲۳ (P< ۰.۰۰۱), though overall resistance remained high; while susceptibility to cefoperazone-sulbactam and piperacillin-tazobactam declined (P< ۰.۰۰۱). K. pneumoniae susceptibility to cefoperazone-sulbactam decreased from ۸۸.۷% in ۲۰۱۸ to ۷۳.۰% in ۲۰۲۳ (P< ۰.۰۰۱). Enterococcus spp. susceptibility to nitrofurantoin declined from ۹۱.۰% in ۲۰۱۸ to ۶۷.۴% in ۲۰۲۳ (P = ۰.۰۱۷). A. baumannii showed increased ceftazidime susceptibility from ۱۸.۴% in ۲۰۱۸ to ۵۶.۰% in ۲۰۲۲, followed by a decline to ۲۷.۸% in ۲۰۲۳ (P = ۰.۰۱۵). P. aeruginosa exhibited increased susceptibility to gentamicin (۵۷.۶% to ۷۷.۲%; P = ۰.۰۱۲), ceftazidime (۶۱.۶% to ۷۷.۲%; P = ۰.۰۴۳), and fluoroquinolones (۵۳.۹% to ۶۸.۱%; P = ۰.۰۱۹) from ۲۰۱۸ to ۲۰۲۳. Conclusion: This study highlights dynamic shifts in antimicrobial susceptibility patterns among uropathogens, underscoring the need for continuous surveillance to guide empirical therapy and infection control strategies. Further research is warranted to explore contributing factors, including pandemic-related practices.

کلیدواژه ها:

Uropathogens ، COVID-۱۹ ، Antibiotic susceptibility ، Drug resistance ، Urinary tract infections ، Kerala ، India