Diagnostic and Therapeutic Approaches in the Management of Genital and Urinary Tract Infections
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Abstract
Background: Genitourinary tract infections (GUTIs) are a significant cause of morbidity in women and have adverse consequences for reproductive and maternal health. Data on the diagnostic and therapeutic management of urogenital infections in Bangladesh are limited. This study aimed to evaluate the diagnostic methods, etiological agents, and antimicrobial sensitivity patterns in women with GUTIs attending a tertiary hospital in Bangladesh.
Methods: This cross-sectional study was conducted at the Department of Obstetrics & Gynecology, Bangladesh Medical University (BMU), Dhaka, Bangladesh, from January to December 2024. A total of 350 women with GUTI symptoms were enrolled. Sociodemographic and clinical data were also collected. Laboratory investigations included urine culture, microscopy, Gram staining, dipstick tests, and PCR, where available. Antimicrobial susceptibility was assessed using the Kirby-Bauer disk diffusion method, following CLSI guidelines. Data were analyzed using SPSS version 25.0.
Results: Most participants were aged 25–34 years (40.0%), pregnant (60.0 %), and urban residents (51.4%). Urine culture was the most frequently used diagnostic method (77.1%), followed by gram staining (60.0%). Escherichia coli was the most common pathogen (40.0%), followed by Klebsiella pneumoniae (16.6%) and Candida albicans (12.9%). Antimicrobial resistance was high, with ciprofloxacin sensitivity ranging from 35% to 52%, while nitrofurantoin (74–81%) and imipenem (>87%) showed better activity.
Conclusion: GUTIs among Bangladeshi women are predominantly caused by E. coli and K. pneumoniae, with concerning levels of antibiotic resistance in the latter. Strengthening diagnostic capacity and antibiotic stewardship is urgently needed.