STUDY FOR MONITORING OF ANTIMICROBIAL RESISTANCE
TRENDS (SMART): A Surveillance of Gram-negative Bacilli Causing
Urinary Tract Infections in Inpatients
Mohd Nazil Salleh, Siti Nur Lina Azman, Henkie Isahwan Ahmad Mulyadi Lai, Seri Ambal
Int. J. Bio. Lab. Sci 2017 6:12-16
Urinary tract infection (UTI) is an infection of one or more structures in the urinary system, most of which is caused by gram-negative bacteria. Study for Monitoring Antimicrobial Resistance Trends (SMART), an ongoing global surveillance program, monitors the susceptibilities of gram-negative bacilli from inpatient with urinary tract infections (UTIs). Materials and Methods; Hospitalised patient (n=200) with clinical features of UTI were evaluated using R/E urine culture and sensitivity test. Isolated pathogen was differentiated using Micronaut-E Identification system whereas determination of in-vitro antimicrobial susceptibility profile was performed using Micronaut-SB analysis. Results; Our results showed that the gram-negative bacilli from UTI isolates was Escherichia coli (52%), Klebsiella pneumoniae (23%), Proteus mirabilis (14%), Acinetobacter spp (5%) and Morganella morganii (5%). Sensitivity testing demonstrated that amikacin was the most effective antibiotic (95% susceptibility) followed by the carbapenem (imipenem) (86%), and ceftazidime (81%). The remaining susceptibility profile was cefaclor (57%), ciprofloxacin (62%) and cefixime (67%). Our findings also showed that the gram-negative bacilli had higher rate of resistance to amoxicillin/clavulanate acid and vancomycin. E. coli and K. pneumoniae are the most common pathogens for the development of UTI. Conclusions; Our findings also address the importance of continuing surveillance of gram-negative bacilli infection in UTI and monitoring the full trend in antimicrobial activities, new resistance mechanism(s), in order to implement effective infection control and ensure the reducing of the antimicrobial resistance.
Key words: Urinary tract infection, monitoring antimicrobial resistance trends (SMART)