Authors : V.S. Wadhai1 and Uma Arun Mandal
Page Nos : 19-28
Description :
Patients with sickle cell disease (SCD) have a substantially high risk of urinary tract infections (UTIs) owing to functional
asplenia, renal medullary pathology, and compromised immunological defenses. Characterizing regional pathogen
profiles and their resistance phenotypes is a prerequisite for rational therapeutic decision-making in this vulnerable
population. To recover and identify uropathogens from urine specimens of patients with SCD, characterize their
antimicrobial susceptibility phenotypes, and formulate evidence-based treatment recommendations applicable to the
regional clinical context. A descriptive cross-sectional study conducted at the Civil Hospital in Chandrapur involved 20
participants who have been confirmed to have sickle cell disease (SCD). The ages of these participants ranged from 5 to
40 years. Midstream urine specimens were cultured on CLED, MacConkey, and Mueller-Hinton agar plates. Found the
isolated samples by applying Gram staining, observing how they moved, and performing a regular set of biochemical
tests. (IMViC, oxidase, catalase). Antimicrobial Susceptibility was assessed using the Kirby-Bauer disk diffusion method
in line with the CLSI 2024 guidelines breakpoints. Eight distinct uropathogens were identified: Escherichia coli,
Enterobacter spp., Pseudomonas aeruginosa, Klebsiella spp., Proteus spp., Staphylococcus aureus, Enterococcus faecalis
and S. saprophyticu, Gram-negative bacilli comprised 62.5% of the total isolates. Ampicillin, penicillin-G, and
erythromycin elicited the highest resistance rates in the study. Amikacin and ciprofloxacin demonstrated the broadest
efficacy against gram-negative organisms. Microbiologically guided therapy is indispensable for UTI management in
patients with SCD. Aminoglycosides and fluoroquinolones are the most dependable empirical choices. Formal
antimicrobial stewardship initiatives and universal urine culture protocols are urgently needed for this high-risk cohort.
