Abstract

EVALUATION OF DIRECT SENSITIVITY TEST FOR URINE

Farukh Ahmad, Sunil Shekhar Ghimire*, Anu Miglani and Virender Singh

ABSTRACT

To evaluate the performance of DST in the setting of acute urinary tract infection (UTI), we performed DST using 20 traditional and contemporary antimicrobial agents on urine specimens from 500 samples suspected acute uncomplicated UTI, and compared these results with the results of standardized disk diffusion susceptibility tests done on the same specimens. Direct tests were interpretable for 161 specimens, i.e., 32.2% of all specimens and 26.8% of the 134 specimens that met the culture criteria for UTI. Errors in DST were common with more resistance drugs eg Tetracycline 153(95%) followed byLomofloxacin146 (90.6%) and Imipenem 141 (87.5%), non-Escherichia coli strains, low urine bacterial concentrations, sparse or mixed growth in the direct test, and the presence of multiple significant organisms in urine. The pyuria was found in majority of cases 155(31%) were having 0-5 pus cells followed by 68 cases having 6-10 pus cells, 8 cases were found to have 11-15 pus cells and only 3 were found to have 16-20 pus cells. Calculation of the sensitivity by DST in identifying antimicrobial resistance supplemented conventional rate analysis. We conclude that when used selectively and interpreted carefully, DST of urine specimens offers an efficient, rapid, and accurate method for antimicrobial susceptibility determination for acute UTI.

Keywords: UTI- Urinary Tract Infection, DST- Direct Sensitivity Test.