Int.J.Curr.Microbiol.App.Sci (2017) 6(9): 2287-2296 2287 Original Research Article https://doi.org/10.20546/ijcmas.2017.609.280 Antimicrobial Resistance among Uropathogenic Bacteria in Rural Kerala, India T. Shailaja Sukumaran and A. Mohan Kumar * Department of Microbiology, PK Das Institute of Medical Sciences, Vaniyamkulam, Palakkad, Kerala, India *Corresponding author ABSTRACT Introduction Urinary tract infection (UTI) is the most common of infections in the clinical practice. Among the bacterial agents of UTI, E. coli continues to be the commonest in both community acquired and hospital acquired cases (Gupta et al., 2002). Other pathogens include Klebsiella, Pseudomonas and other non-fermenters, Enterococcus, Staphylococcus, Enterobacter, Citrobacter, Proteus, etc. Over the last decade there has been an alarming increase in antimicrobial resistance (AMR) among the common bacterial agents of UTI in developing and developed countries. In this context, the empirical antibiotics used earlier in UTI such as ampicillin/amoxicillin, co-trimoxazole, norfloxacin, ciprofloxacin, etc. can no longer be used confidently. In the recent years antibiotic resistance is becoming a major problem not only in hospital acquired complicated UTIs but also in uncomplicated community acquired cases (Kavya et al., 2016) which makes the treatment of UTI more complex. On reviewing the literature it International Journal of Current Microbiology and Applied Sciences ISSN: 2319-7706 Volume 6 Number 9 (2017) pp. 2287-2296 Journal homepage: http://www.ijcmas.com Urinary tract infections caused by multidrug resistant bacteria are increasingly becoming prevalent even in rural areas. Objective of the present study was to find out the distribution and antibiotic resistance pattern of urinary isolates over a period of one year in a tertiary care centre of Central Kerala which has got a rural location. We analyzed the types and antibiotic resistance pattern of all significant urinary isolates in the microbiology department from May 2016 - April 2017. Of the 3772 urine samples processed, 1265(33.5%) showed significant bacteriuria. The predominant isolate was E. coli (48.9%) followed by Klebsiella sp. (14%), Enterococcus sp. (14%), Staphylococcus sp. (7%), Pseudomonas and other non-fermenters (11%). Among Enterobacteriaceae, 64.7% was ESBL producers and 15.75% were carbapenem resistant. Around 63% of E.coli and Klebsiella sp. were found to be resistant to fluoroquinolones like norfloxacin and ciprofloxacin. Ampicillin resistance was observed in 35% of Enterococcus isolates and vancomycin resistance in 0.65%. Of the Staphylococcal isolates, 79.5% was methicillin resistant. From our study, we could realize that the problem of antibiotic resistance is increasing in an alarming rate even in rural areas. Multidrug resistance, since being a universal problem, we all have to be vigilant against this menace and the need for antibiotic stewardship should be reiterated. Keywords Urinary isolates, Antibiotic resistance, Rural India. Accepted: 23 July 2017 Available Online: 10 September 2017 Article Info