Research Journal of Medical Sciences
ISSN: Online 1993-6095ISSN: Print 1815-9346
195
Views
22
Downloads
Abstract
Infections of the genitourinary tract are a common cause of morbidity in both healthy and immunocompromised individuals. Urine analysis, microscopy, culture and antibiotic susceptibility testing are clinical microbiology procedures that aid in the diagnosis and elucidation of UTI etiology. The presence of antibiotics in urine samples presented for culture might further complicate the identification of UTIs, especially when they are easily accessed without a prescription. This condition may impair bacterial pathogen recovery and precise colony count, resulting in false-negative findings and diagnostic problems, especially in symptomatic patients. Antibiotics can temporarily reduce bacterial counts per milliliter of urine, resulting in a transient remission of clinical symptoms, which can obscure treatment success in chronic or recurrent asymptomatic infections. Therefore, we aimed to study the association between data collection from patients pertaining to antibiotic history and the presence of AMS in urine samples, to construe the effect of antibiotics in diagnosis of UTIs and correlate the presence of AMS in urine with culture outcome also to study antibiotic susceptibility pattern of bacteria isolated from such urinary tract infections. During a year and a half study period, a prospective study was carried out with three hundred cases of patients who visited the genitourinary OPD of the tertiary care setting and were instructed to get a microbiological investigation of urine culture and sensitivity. Patients who were first-time OPD visitors with signs and symptoms of UTI were included. In addition to obtaining a thorough history from each patient and filling out a proforma, these patients were asked whether they had recently or presently consumed any antimicrobial agents. After collection of midstream urine samples from the patients, these samples were subsequently subjected to standard microscopy, a microbiology test for the presence of AMS, culture identification and antibiotic susceptibility in accordance with CLSI criteria. Majority 29.1% (87) of the cases observed were from the age group 21-30 years with female predominance observed among the study population. The signs and symptoms observed were abdominal pain 73% (219), increased frequency 61% (183), fever with chills 37.3% (122), followed by dysuria 30.6% (92) and 4% (12) cases of blood in urine. Out of the 300 cases observed, 23% (69) cases had AMS in the samples. 29.0% (20) of AMS cases had Obstructive pathology followed by Diabetes Mellitus 5.8% (4) and 01.4% (1) case of pregnancy was observed under comorbidities. 40.8% (29) of cases who were on Antibiotic had AMS which was significantly higher (p = 0.001) as compared to the 17.5% (40) of cases who were not on Antibiotics but had AMS. It was observed that, 27.6% (35) of the cases having adequate history on requisition forms had AMS which was higher than the 19.7% (34) cases who did not have adequate history on requisition forms. Amongst the 20 uropathogens obtained among AMS patients, the most common organism was E. coli 40% and 20% CONS (coagulase negative staphylococcus) while Enterococcus species, Pseudomonas aeruginosa, Acinetobacter species, Proteus Mirabilis were found to be 5%. Presence of antimicrobial substances in urine has a great impact on the interpretation of urine culture reports as the antimicrobial substances tend to lower the microbial counts leading to false negative reports and undiagnosed UTI. While this can be prevented by obtaining adequate patient history including the intake of antibiotics, in most cases, the patient fails to provide the information as they are either not well informed about their medicinal intake or due to the easy availability of antibiotics over-the-counter the patient fails to report the same which leads to false negative reports of the urine sample hence a delay in diagnosis and treatment.
How to cite this article:
Arundhati Paul, Shripad Taklikar, Sujata Baveja and Sujata Chavan. A Study of Antimicrobial Substances in Urine in Patients Attending the Outpatient Department in a Tertiary Care Hospital.
DOI: https://doi.org/10.36478/10.59218/makrjms.2023.9.64.69
URL: https://www.makhillpublications.co/view-article/1815-9346/10.59218/makrjms.2023.9.64.69