Gram-positive uropathogens: Empirical treatment and emerging antimicrobial resistance

Urinary tract infection (UTI) is a global problem. Most UTI research focuses on gram-negative etiology. Enterobacteriaceae was found to be the most prevalent UTI infection constituting more than 80% of all the reported cases. The major gram-positive bacteria in UTI cases are Staphylococcus saprophyticus, Enterococcus faecalis, Streptococcus agalactiae. Gram-positive pathogens were reported in multiple countries in both uncomplicated and complicated UTI. Antibiotic therapy of gram-positive bacteria is completely different than that of gram-negative UTI pathogens. However, symptoms associated with UTI caused by gram-positive and gram-negative are very similar. Without proper diagnosis, there is a high possibility of getting the wrong diagnosis and subsequent antibiotic therapy. Very limited studies are available focusing etiology and their antibiotic susceptibilities in Bangladesh perspective. We aimed to seek in this gap-filling research area. This study has detected 8.2% of gram-positive bacteria in UTI patients. The prevalence shows the harmony with the earlier published reports. Male and female were found to be infected equally by gram-positive UTI pathogens. Most of the earlier publication shows that female is more vulnerable to gram-negative UTI bacteria. Unlikely, our findings look males are equally vulnerable by gram-positive in comparison to females. Further studies with more sample sizes can warrant the preliminary findings. Antibiogram analyses showed amikacin and gentamicin as the most effective antibiotics against our tested isolates. In contrast, nitrofurantoin was found the most ineffective drug in this study. Findings of the study could help in prescribing antibiotics from this evidence-based study. *Correspondence to: Umme Laila Urmi, Department of Microbiology, Jahangirnagar University, Savar, Dhaka, Bangladesh, Tel: +880-1725996390; E-mail: ummelailaurmi@gmail.com