Emerging spectrum of antimicrobial resistance among uropathogens in a south Indian diabetic population – A dual burden perspective

Abstract

Urinary Tract Infections (UTIs) are a frequent burden among the patients with diabetes mellitus (DM). glycosuria, metabolic syndrome and compromised host immunity make diabetics more vulnerable to infections that occur frequently. The combined burden of DM and antimicrobial resistance is exacerbated by uropathogens growing resistance to antibiotics, which makes treatment more difficult and presents more healthcare issues. To ascertain the spectrum of uropathogens and the patterns of antibiotic sensitivity in individuals with DM who have UTIs, this crosssectional study was carried out in a South Indian multispeciality hospital. Standard microbiological techniques were used to process urine samples from diabetic individuals who had suspected UTIs. A total of 223 isolates were found, comprising of 127 Gramnegative bacteria, 31 Gram-positive bacteria and 30 Candida species. Testing for antimicrobial susceptibility was carried out. Escherichia coli (n = 73) and Klebsiella pneumoniae (n = 45) were the most common Gram-negative isolates. Gram-negative isolates were shown to be highly susceptible to fosfomycin (93.2%), cefoperazone–sulbactam (89%), meropenem (86.3%) and norfloxacin (82.2%) whereas gentamicin (76.7%) and amikacin (75.5%) were found to be more resistant. High susceptibility to glycopeptide antibiotics was shown by Gram-positive isolates. Candida albicans demonstrated 100% susceptibility to flucytosine and 91.7% susceptibility to amphotericin B among fungal isolates. The hierarchically clustered analysis used Euclidean distance. R and Graphpad Prism. The results emphasize how DM and antibiotic resistance coexist in UTI. To enhance patient outcomes and prevent the spread of resistant uropathogens, cultureguided antimicrobial treatment, stringent glucose control and ongoing monitoring are crucial.