Determination of ESBL Production & Antibiotic Resistance Profile of Escherichia Coli Isolated from Patients with Urinary Tract Infections: A Study from Tertiary Care Hospital

2020 ◽  
Vol 7 (1) ◽  
pp. 23-29
Author(s):  
Gunjal P. N. ◽  
Gunjal S. P.
Keyword(s):  
Urinary Tract ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Multidrug Resistant ◽  
Care Hospital ◽  
Esbl Production ◽  
Sensitivity Testing ◽  
E Coli ◽  
Tract Infections

Urinary tract infection (UTI), is defined as a disease caused by invasion of urinary tract by microorganisms. Majority of UTI cases are due to bacterial infection constitute about 95% of total UTI cases. About 80% of UTI cases are caused by E.coli producing extended spectrum ?-lactamase (ESBL) producing isolates. In recent years limitations in treating infections caused by multidrug resistant organisms has increased. This study aims to determine ESBL production of E. coli cases from a tertiary care hospital. Methodology: A total 358 midstream urine samples were collected by random sampling method during March 2015 to June 2018. Identification, antibiotic sensitivity testing, performed according to standard protocol following Clinical and Laboratory Standard Institute (CLSI) guidelines, 2013. Screening for ESBL producing E.coli isolates performed using ceftazidime further confirmation done by phenotypic disc diffusion test using combined disc method using ceftazidime (30µg) & ceftazidime/ clavulanic acid (30/10 µg) as per CLSI guidelines. Results: Total 358 specimens processed for urine culture. Gram negative bacilli isolated from 123(34.35 %), out of which 68 (55.28%) were E.coli, 19 (15.44%) K. pneumoniae, 15 (12.19%), Pseudomonas spp. 08 (6.50%), Citrobacter spp and Acinetobacter spp, 03 (2.43%), Proteus mirabilis, 01 (0.81%) Proteus vulgaris and Enterobacter respectively. Out of 68 isolates of E.coli, 65 (95.58%) were MDR, ESBL was detected in 31 (47.69%) out of these 65 isolates. Out of these 31 cases 19 (61.29%) were female and 12 (38.70%) were male cases. Conclusion: This study concludes 47.69% ESBL producing MDR E. coli were isolated from UTI cases with female predominance.

scholarly journals Multidrug-resistant urinary tract isolates of escherichia coli: Frequency and patient demographics in a Tertiary Care Hospital.

2020 ◽  
Vol 27 (02) ◽  
pp. 335-340
Author(s):  
Salman Azhar ◽  
Muhmmad Wasif Baig ◽  
Shahid Rasool ◽  
Rizwan Rasool Khan ◽  
Talha Munir ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Multidrug Resistant ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Cross Sectional ◽  
E Coli ◽  
Patient Demographics ◽  
Tract Infections

Urinary tract infections (UTIs) are a major burden to the health care as it is estimated that around 150 million UTIs occur yearly worldwide. Enterobacteriaceae are the most common agent causing serious urinary tract infections; and MDR cases are increasing day by day. Objectives: To determine the frequency and patient demographics of multidrug resistant urinary tract isolates of Escherichia Coli in a Tertiary Care Hospital. Study Design: Retrospective cross sectional study. Setting: Medicine Department of Madinah Teaching Hospital / The University of Faisalabad, Faisalabad. Period: From May 2016 to Sep 2018. Material & Methods: 187 patients of age 15 to 90 years with positive E. coli on urine culture and sensitivity were included in this Retrospective cross sectional study. All those patients with history of dysuria (pain during urination) or frequent urination (more than 7 times per day) were advised urine complete analysis and those with >5 WBCs or pus cells /HPF or having positive for leukocyte esterase and/or nitrite, were advised urine culture and sensitivity. Main outcome variable was the frequency of MDRE cases among the culture positive E. coli UTI patients. Results: Among all the cases of E. coli UTI, frequency of MDRE UTI was 66.8% (n=125) and rest 33.2% (n= 62) cases were not MDR UTI. 97.3% patients were resistant to lactam antibiotics, 95.7% were resistant to quinolones and 68.4% were resistant to aminoglycosides.

scholarly journals Phenotypic and genotypic characterization of multidrug-resistant isolates from patients with catheter-associated urinary tract infection in a tertiary care hospital

2019 ◽  
Vol 11 (03) ◽  
pp. 206-211
Author(s):  
Jaison Jayakaran ◽  
Nirupa Soundararajan ◽  
Priyadarshini Shanmugam
Keyword(s):  
Urinary Tract ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Carbapenem Resistance ◽  
Multidrug Resistant ◽  
Diffusion Method ◽  
Care Hospital ◽  
Disk Diffusion Method ◽  
Carbapenem Resistant ◽  
Tract Infections

Abstract INTRODUCTION: Urinary tract infections (UTIs) remain as the most common infection. Catheter-associated (CA) UTI can lead to bacteremia and thereby is the leading cause of morbidity and mortality in hospitalized patients in our country. AIMS AND OBJECTIVES: This study aims to check the prevalence of CAUTI and study the phenotypic and genotypic characters of the multidrug-resistant organisms in a tertiary care hospital, with special reference to NDM-1 and OXA-23. MATERIALS AND METHODS: A total of 231 urine samples from patients with CA-UTI in different wards in a tertiary care hospital over a period of 3 months between June and August 2018 were collected and processed following the standard protocol. Antibiotic susceptibility tests were performed by disk-diffusion method. Modified Hodge test (MHT) was done to isolate carbapenem-resistant isolates, and polymerase chain reaction was done to detect NDM-1 and OXA-23. RESULTS: Out of 231 samples, 101 samples yielded significant growth. These 38 samples were Gram-negative bacilli which were resistant to carbapenems. Out of the 38 which showed carbapenem resistance, 23 were MHT positive. Out of the 23 MHT-positive isolates, 8 (21.05%) were positive for NDM-1 gene and only 1 (2.6%) was positive for the OXA-23 gene. CONCLUSION: This study has shown that carbapenem-resistant isolates from all the CA urinary tract-infected patients were 52.77% and most of them were Klebsiella. About 21% of them harbored the NDM-1 gene whereas only 2% had the OXA-23 gene. There has been an alarming increase in the spread of carbapenem resistance.

scholarly journals Antibiotic sensitivity pattern of pathogens in children with urinary tract infection in a tertiary care hospital in Kachchh, Gujarat, India

2017 ◽  
Vol 4 (6) ◽  
pp. 2103
Author(s):  
Rekha Thaddanee ◽  
Gurudas Khilnani ◽  
Nupur Shah ◽  
Ajeet Kumar Khilnani
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Care Hospital ◽  
Coagulase Negative Staphylococci ◽  
E Coli ◽  
Sensitivity Pattern

Background: This prospective observational study was conducted in a tertiary care hospital in Kachchh, over a period of 6 months, to know the antibiotic sensitivity pattern of pathogens in children less than 18 years old with Urinary Tract Infection (UTI).Methods: Between December 2016 to June 2017, 186 children met the inclusion criterion. Urine samples were collected and processed for urine routine microscopy, culture and antibiotic sensitivity as per the standard laboratory guidelines. Urine culture was positive in 50 cases, which were further evaluated to find out any renal disease. All patients were given 10-14 days antibiotics course and follow-up urine reports were done. Patients were considered cured when the follow-up urine reports were normal.Results: E. coli was the commonest organism (34%) isolated, found mainly in 1-5 years age group (20%). Enterococci were isolated in 32% cases, most of which were less than 5 years of age (28%). Klebsiella (12%), Methicillin Resistant Staphylococcus Aureus (MRSA) (10%), Coagulase negative staphylococci (6%), Pseudomonas (2%) and Budding yeast cell (4%) were the less frequent organisms isolated. E. coli were found to be less sensitive to different Aminoglycosides (11.7% - 23.5%), Cephalosporins (11.7% - 52.9%), Fluoroquinolones (5.8% - 11.7%), Co-trimoxazole (17.6%) and Piperacillin (17.6%), but were more sensitive (70.6%) to Imipenems. Enterococci were also partially sensitive to Aminoglycosides (6.2-18.7%), Cephalosporins (25-37.5.7%), Fluoroquinolones (6.25-12.5%), Penicillin-G (50%), Piperacillin (31.25%) and Co-trimoxazole (43.75%), but had good sensitivity for Imipenems (68.7%), Linezolid (75%) and Vancomycin (81.2%). Similarly, MRSA was 100% sensitive to Linezolid and Imipenem but partially sensitive (20-60%) to other antibiotics. Klebsiella showed 16.65-33.3% sensitivity to all antibiotics except Imipenem (83.3%) and was 100% resistant to Co-trimoxazole. Coagulase negative Staphylococci (CONS) remained 100% sensitive to all antibiotics and Pseudomonas was resistant to all antibiotics.Conclusions: The study concludes that pathogens for UTI in children have developed resistance, even to the newer generation antibiotics, probably due to the irrational use of antibiotics. In view of emergence of multi drug resistant pathogens, which carry considerable morbidity and mortality, every effort must be taken to use antibiotics judiciously.

scholarly journals Incidence and Susceptibility of Uropathogens Isolated among the Patients at Tertiary Care Hospital in Eastern Nepal

2016 ◽  
Vol 5 (2) ◽  
pp. 51-55 ◽  
Author(s):  
Bigu Kumar Chaudhari ◽  
Ganesh Kumar Singh ◽  
Kamal Prasad Parajuli ◽  
Kewal Shrestha
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Diffusion Method ◽  
Care Hospital ◽  
E Coli ◽  
Medical College ◽  
Tract Infections

Background Urinary Tract Infection (UTI) is one of the most common infectious diseases which affect almost all ages groups of population. Production of â-lactamases is responsible for antibacterial resistance which is frequently observed in Enterobacteriaceae isolates, particularly by E. coli and Klebsiella pneumoniae. This investigation has been carried out to determine the current status of prevalence and susceptibility of uropathogens isolated among the patients at tertiary care hospital in eastern Nepal.Material and Methods This study was done at the department of Microbiology, Nobel Medical College Teaching Hospital, Biratnagar, Nepal during May 1st 2015 to October 31st 2015. Midstream cleancatch urine was sampled from 1730 suspected urinary tract infection patients of different age and sex groups. Uropathogens were recognized in term of standard and specific microbiological techniques and antimicrobial susceptibility pattern was determined by Kirby Bauer Disc diffusion method following Clinical and Laboratory Standards Institute (CLSI) guidelines.Results Out of 1730 suspected specimens Culture resulted a total of 761 (43.98 %) positive and 969 (56.02%) negative among that significant growths of uropathogens including 700 (91.98 %) unimicrobial and 60 (7.88 %) polymicrobial growths. In term of Gender distribution 443 (25.60 %) were male and 1287 (74.40 %) were female hence the ratio is 0.34:1, respectively. E. coli was the leading isolate (66 %), followed by Klebsiella spp. (12 %), Enterococcus spp. (8 %), Pseudomonas spp. (6 %), Acinetobacter anitratus (5 %), Proteus spp. (3 %).Conclusion The high frequency of multidrug resistance in bacterial uropathogens was seen. Principally, resistance patterns were seen higher for amoxycillin, co-trimoxazole, flouroquinolones and third-generation cephalosporins, Existing uropathogens highlights the highest rate of vulnerability to nitrofurantoin, amikacin and gentamicin which provide much better antibiotic coverage and can be adapted for practical treatment of urinary tract infections.  Journal of Nobel Medical College Vol.5(2) 2016; 51-55

scholarly journals Microbes and antibiotic susceptibility patterns of urinary tract infections in toilet-trained Children at a Tertiary Care Hospital of Sialkot, Pakistan.

2021 ◽  
Vol 28 (01) ◽  
pp. 22-26
Author(s):  
Syed Muhammad Hassan Akhtar ◽  
Abdul Sattar ◽  
Wajiha Rizwan ◽  
Naeem Ahmed Cheema ◽  
Aftab Anwar
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Rural Areas ◽  
Urine Analysis ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Care Hospital ◽  
Amoxicillin Clavulanate ◽  
Tract Infections

Objective: To find out various types of microorganisms causing urinary tract infections and their antibiotic sensitivity patterns among toilet-trained children presenting at a tertiary care hospital of Sialkot District. Study Design: Descriptive study. Setting: Department of Microbiology/Urology, Khawaja Muhammad Safdar Medical College, Sialkot. Period: June to December 2019. Material & Methods: A total of 176 toilet trained children, aged 7 to 15 years, presenting in outpatient department and having culture positive urinary tract infections were enrolled. Demographic information like age, gender and area of residence along with clinical findings, antibiotic sensitivities and resistance patterns were recorded. Mid-stream urine sample was collected from all toilet-trained children and immediately sent to institutional laboratory for urine analysis and urine culture and sensitivities. Results: Out of a total of 176 children, 95 (54.0%) were female and 81 (46.0%) male. Overall mean age was noted to be 10.68+2.42 years while most of the children, 94 (53.4%) were above 10 years of age. Majority of the patients, 98 (55.7%) belonged to rural areas. Eschericia coli were the most common isolate, found among 140 (79.5%) children. Imipenem (98.9%), meropenem (98.9%), piperacillin tazobactam (97.7%), fosfomycin (96.6%), amikacin (95.5%), nitrofurantoin (84.4%), gentamycin (90.9%) and amoxicillin clavulanate (83%) were found to have the highest sensitivities. Conclusion: Eschericia coli were the most common bacterial urinary pathogens in toilet-trained children. Amoxicillin clavulanate, Nitrofurantoin and Fosfomycin available in oral form showed good sensitivity of 83%, 84.4%, and 96.6% respectively) to commonly found microorganisms. It was also noted that resistance to commonly used antibiotics in our region is rising.

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