Evaluation of Pathogens Causing Urinary Tract Infection and Their Sensitivity Pattern

Background: UTI constitute a major public health problem in India accounting 2nd most common infection next to respiratory tract infection. They are responsible for increasing treatment cost and significant morbidity.Aim:-To determine the incidence of UTI, evaluation of pathogens responsible and their antimicrobial susceptibility pattern in the population.Methods:Urine samples were collected from 300 patients attending the OPD Patna medical college, Patna during the period of 18 months (January 2017 to June 2018) Antimicrobial sensitivity testing was done for the bacterial isolates present in the sample by Kirby- Bauer disc diffusion method. Only those samples were taken into consideration which develops count equal to or greater than 1*105CFU/ml as indicated by Kass.Results:Out of 300 samples collected 146 (48.66%)) yielded bacterial growth. Out of 146 culture isolates E.Coli was the most common pathogen followed by klebsiella, CoNS and staphylococcus. Antibiotic sensitivity was performed on all the isolates. It was observed that highest sensitivity was 49.31% to amikacin, gentamycin (45.89%), nitrofurantoin (38.35%) meropenem (27.39%).Conclusions:It was observed that high grade of resistance to ampicillin, cotrimoxazole, ciprofloxacin, cefuroxime, chloramphenicol, cefotaxime, cefazolin, amoxicillin + clavulanic acid and gentamycin is present as a result of misuse or improper use of antibiotic in the community. Hence urine culture is necessary for the diagnostic screening of UTI before the treatment.

High prevalence and antimicrobial susceptibility pattern of salmonella species and extended-spectrum β-lactamase producing Escherichia coli from raw cattle meat at butcher houses in Hawassa city, Sidama regional state, Ethiopia

Background Food-borne diseases related to the consumption of meat and its products had public health importance worldwide. The problem became worst in Ethiopia as the result of the tradition of eating raw cattle meat. Salmonella species and Escherichia coli are important food-borne pathogens associated with meat contamination. Hence the current study aimed to assess the prevalence and antimicrobial susceptibility of Salmonella species and Extended-spectrum β-lactamase producing Escherichia coli from raw cattle meat at butcher houses in Hawassa city, Sidama regional state, Ethiopia. Method A cross-sectional study was done on the prevalence and antimicrobial susceptibility pattern of Salmonella species and Extended-spectrum β-lactamase producing E.coli from raw cattle meat at butcher houses in Hawassa city from September to December 2020. Socio-demographic data were collected using a structured questionnaire and raw cattle meat and swab samples were collected from meat cutting equipment. The collected samples transported using icebox to Hawassa University College of Medicine and Health Sciences Microbiology Laboratory for identification. Samples were grown on different culture media and antimicrobial susceptibility tests were determined by using Kirby disc diffusion method. Data were entered and analyzed into SPSS version 23. Descriptive statistics were done and P-value < 0.05 was considered as statistically significant. Result The overall prevalence of salmonella and ESBL producing E.coli among 556 samples collected from 278 butcher houses was 36 (6.47%) (95% CI: 1.68–1.79) of which 13 (2.3%) were ESBL producing E.coli and 23(4.1%) were salmonella species. Poor hand washing practice (AOR = 2.208; 95% CI: 1.249–3.904) and touching birr while selling meat (AOR = 0.75; 95% CI: (0.433–1.299) were found to be significantly associated with the prevalence of salmonella species and E.coli on cattle meat. The isolates showed moderate levels of resistance (60–70%) against Amoxicillin/ clavulanic acid and high susceptibility (85–100%) against gentamicin, cotrimoxazole, ceftazidime, and tetracycline and the overall multidrug resistance was 33.3%. Conclusion This study revealed moderately high prevalence of salmonella and E.coli due to poor hygiene and sanitation practices in the butcher shops. Furthermore, the existence of ESBL producing E.coli isolates clearly indicate the possible threat to public health. Therefore, inspection by the right agencies must be implemented in order to prevent food-borne outbreaks and antimicrobial resistance.

Frequency and Antimicrobial Susceptibility Pattern of Gram-Negative Bacilli Isolated From Urine Specimens at a Tertiary Care Setting

OBJECTIVES: To find out the frequency and pattern of conventional antibiotic susceptibility of gram-negative bacilli cultured from urine specimens of patients at a tertiary care setting. METHODOLOGY: This study was conducted at the Microbiology Department of Combined Military Hospital Multan from June 2016 to May 2017. The data in this retrospective descriptive study was collected from urine culture records of the Microbiology Department, CMH Multan. Only those urine specimens who revealed positive gram-negative bacilli cultures were included in the study. Drug susceptibility patterns of these isolates were recorded against routinely used antibiotics (e.g. Nitrofurantoin, Imipenem, Sulbactum-cefoperazone, Gentamicin and Ciprofloxacin) and evaluated accordingly. RESULTS: A total of 1703 urine specimens were submitted for culture and antibiotics susceptibility testing during the period of study. A total of 128 specimens showed growth of gram-negative rods. Imipenem (95% sensitivity), Sulbactam- Cefoperazone (88% sensitivity) and Nitrofurantoin (87% sensitivity) were highly effective antibiotics against the cultured gram-negative bacilli in the study. CONCLUSION: This study showed that E. coli is the commonest cause of urinary tract infection (UTIs), followed by Klebsiella and Enterobacter species among gram-negative bacilli in our set up. In-vitro efficacy of Imipenem, Sulbactam- Cefoperazone and Nitrofurantoin was found to be the highest against these gram-negative bacilli as compared to other antimicrobials. On the contrary, in-vitro efficacy of ciprofloxacin and gentamycin was found to be extremely low.

A study of biofilm production and antimicrobial susceptibility pattern among urinary isolates

Urinary tract infection (UTI) is the most commonly acquired bacterial infection. Bacterial biofilms play an important role in urinary tract infections and are responsible for persistent infections as well as higher antimicrobial resistance. The microbial biofilms pose a public health problem as the microorganisms in the biofilms are difficult to treat with antimicrobial agents. So the present study was undertaken with the aim to study biofilm production and antimicrobial susceptibility pattern of urinary isolates. Aerobic bacterial isolates from urine samples submitted to microbiology laboratory for culture were included in the study. The isolates were tested for biofilm formation by Congo red agar method and Christensen tube method. Antimicrobial susceptibility tests were performed on these isolates by Kirby Bauer disk diffusion method as per CLSI guidelines. A total of 293 Gram negative bacilli and 59 Gram positive cocci were tested for biofilm production and antimicrobial susceptibility testing. : Gram‑negative organisms were predominant (83.24%) of all the isolates. Biofilm production was detected in 47% of the isolates. 51.7%), were the most common biofilm producing Gram negative bacilli followed by (44.32%). Amongst Gram positive cocci, (77.8%) was the most common biofilm producing organism. Biofilm producing urinary isolates displayed relatively less percentage of antimicrobial susceptibility than biofilm non producers. Biofilm forming isolates showed higher antimicrobial resistance as compared to biofilm non producer. Early detection of biofilm production in urinary isolates may aid clinicians in treatment of urinary tract infections.

Characterization of biofilm producing methicillin resistant coagulase negative Staphylococci from India

Methicillin-resistant coagulase-negative staphylococci (MR-CoNS) cause infectious diseases due to their potential to form biofilm and further colonization in hospital materials. This study evaluated the antibiotic susceptible phenotypes, biofilm-producing ability, and biofilm-associated genes (mecA, icaAD, bap, cna, and fnbA). Biofilm formation was detected through Congo red agar (CRA) method and MTP method. The presence of biofilm and associated genes in MR-CoNS were detected by PCR. A total of 310 (55.95%) isolates produced the biofilm. Among these isolates, Staphylococcus haemolyticus (34.83%), Staphylococcus epidermis (31.93%), Staphylococcus capitis (16.77%), Staphylococcus cohnii (10.96%), and Staphylococcus hominis (5.48%) were identified. The antimicrobial susceptibility pattern of CoNS isolates indicated resistance to cefoxitin (100%), erythromycin (94.8%), ciprofloxacin (66.7%), sulfamethoxazole/trimethoprim (66.7%), gentamicin (66.12%), and clindamycin (62.9%). Resistance rate to mupirocin was 48.5% in S. epidermidis and 38.9% in S. haemolyticus isolates. All isolates were sensitive to vancomycin and linezolid. The prevalence rates of icaAD, bap, fnbA, and cna were 18.06%, 12.5%, 47.4%, and 27.4%, respectively. icaAD and bap genes were detected in 18.06% and 12.5% of MR-CoNS isolates. fnbA and cna genes were detected in 47.41% and 27.41% of MRCoNS isolates. icaAD positive strains exhibited a significant increase in the biofilm formation compared with those that lacked icaAD (0.86 (0.42, 1.39) versus 0.36 (0.14, 0.75), respectively; P < 0.001). In conclusion, the majority of MR-CoNS isolates were biofilm producers, and S. capitis, which possessed icaAD genes, ranked as the great biofilm producer than other Staphylococcus. The study’s findings are important to form a strategy to control biofilm formation as an alternative strategy to counter the spread of MR-CoNS in healthcare settings.

Antimicrobial Susceptibility Pattern and ESBL Prevalence of Bacteria Isolated from Street Vended Snacks

Aims: The objective of the study was to ascertain the antimicrobial susceptibility pattern and ESBL prevalence of bacteria isolated from snacks. Place and Duration of Study: Department of Microbiology (Laboratory Unit) Michael Okpara University of Agriculture Umudike. Methodology: The snacks were mashed aseptically, serially diluted and inoculated onto nutrient agar and MacConkey agar. Isolates were identified using standard microbiological procedures. Antimicrobial susceptibility of the isolates and ESBL detection was done using disk diffusion method. ESBL production was confirmed using Double Disc Synergy Test (DDST) method following CLSI recommendations. Results: Escherichia coli, Salmonella Typhi, Staphylococcus aureus and Klebsiella pneumoniae were the bacteria isolated with Escherichia coli as the most prevalent isolate with 42% occurrence in the samples screened. There was significant difference in the sensitivity of the bacteria isolates to the different antibiotics used at P=0.05. Salmonella Typhi isolates exhibited highest resistance to an antibiotic with 86% resistance to ciprofloxacin while Klebsiella pneumoniae isolates exhibited the lowest resistance to an antibiotic with 10% resistance to cefotaxime. Among the Gram-negative bacteria, 36% of suspected ESBL producing E. coli isolates were confirmed as ESBL producers indicating the highest occurrence. Conclusion: The study confirmed the presence of bacteria in street vended snacks which exhibited high resistance to antibiotics that could be attributed to the presence of ESBL producers among the isolates.

Asymptomatic Bacteriuria, antimicrobial susceptibility pattern and associated risk factors among pregnant women attending antenatal care in Assosa General Hospital, Western Ethiopia

Background Asymptomatic bacteriuria is a common problem in pregnant women and about 40% of women with untreated asymptomatic bacteriuria during pregnancy develop pyelonephritis, which might lead to low birth weight, premature rupture of membranes, and preterm labour. Therefore, this study aimed to assess the prevalence of asymptomatic bacteriuria, antimicrobial susceptibility pattern of the isolates among pregnant women attending the antenatal care of Assosa general hospital, western Ethiopia. Methods A facility-based cross-sectional study was conducted from January to February 2019. Two hundred and eighty-three pregnant women with no symptoms of urinary tract infections participated in the study. Bacterial isolates were identified as per the standard bacteriological procedure using colony characteristics, Gram-staining, and series of biochemical tests. Antimicrobial susceptibility test was carried out by Kirby- Bauer disk diffusion technique on Muller-Hinton agar medium and the diameter of zone of inhibition was interpreted according to Clinical Laboratory Standard Institute guidelines. Results The overall prevalence of asymptomatic bacteriuria among pregnant women in this study was 13.78% (i.e. 39 out of 283 urine samples were positive for bacterial isolates). E. coli was the most predominant isolate (53.8%) followed by K. pneumoniae (17.95%), S. aureus (15.4%), and coagulase-negative staphylococci (12.8%). Gram-negative bacteria were highly resistant to tetracycline (96.4%), and ampicillin (90.5%). Conclusion Significant bacteriuria was observed in asymptomatic pregnant women. A large number of the bacterial isolates were resistant to the commonly used antimicrobial drugs.

A Study on Bacterial Etiology of Cholecystitis due to Gallstones and their Antimicrobial Susceptibility Pattern in A Tertiary Care Hospital

Cholelithiasis is a very common condition affecting the Gallbladder. Gallstones are present in 10 -15 % of the adult population. Females are three times more likely to develop Gallstones than male. Gall stones are classified into cholesterol and pigment stone. About 80% of them are cholesterol stone and 15-20% pigment stone. Obstruction and infections are the common complications of Cholelithiasis. Approximately 1-2% of the patients become symptomatic and warrants cholecystectomy (1). With this background we conducted a cross sectional study in the Institute of Microbiology, MMC & RGGGH, for 72 consecutive patients who underwent cholecystectomy. The most common age group affected 41-60 yrs. The most common symptoms are abdominal pain, dyspepsia and Jaundice. In this study Gallstones are collected after surgery, processed and Antibiogram pattern also studied as per standard guidelines. Out of 72 samples studied 35 (48.6%) are culture positive. Escherichia coli is the predominant organism isolated followed by Klebsiella pneumonia(52). Most of the isolates were sensitive to commonly used antibiotics for Gram Negative bacilli.

Prevalence and Antimicrobial Susceptibility Pattern of Salmonella in Selected Export Abattoirs, East Shewa, Ethiopia

The full text of this preprint has been withdrawn by the authors due to author disagreement with the posting of the preprint. Therefore, the authors do not wish this work to be cited as a reference. Questions should be directed to the corresponding author.