Escherichia coli and Klebsiella pneumoniae Sensitivity/Resistance Pattern Towards Antimicrobial Agents in Primary and Simple Urinary Tract Infection Patients Visiting University Hospital of Jamia Hamdard New Delhi

Drug Research ◽  
2018 ◽  
Vol 68 (07) ◽  
pp. 415-420 ◽  
Author(s):  
Mohd Rizwan ◽  
Mohd Akhtar ◽  
Abul Najmi ◽  
Kuldeep Singh

Abstract Aim This study was carried out to record the sensitivity/resistance pattern of Escherichia coli and Klebsiella pneumoniae towards antimicrobial drugs prescribed to urinary tract infection (UTI) patients. Materials and Methods A total of 68 bacteriologically proven simple UTI patients were included in the study, based on inclusion and exclusion criteria. Subjects demographics, antibiotics prescribed, sensitivity pattern of antibiotics towards the urinary pathogens were recorded in drug utilization and documentation form. Results The mean age of the patients was 29.32 years. The maximum number of patients fell under the age group 21–30 years. The maximum no of male and female patients belonged to the age group 21–30 years, 82.35% were females and 17.64% were males. E. coli found to be the most common uropathogens followed by Klebsiella pneumoniae. Nitrofurantoin was the most commonly prescribed drug followed by ciprofloxacin, levofloxacin and amoxicillin + clavulanic acid and amikacin. E. coli isolates showed high resistance for ampicillin followed by cotrimoxazole, norfloxacin, ciprofloxacin, gentamicin, tetracycline and ceftazidime and least resistance to amikacin, nitrofurantoin. Klebsiella pneumoniae isolates were highly resistant against ceftazidime, ampicilline, cotrimoxazole, nitrofurantoin, gentamicin, amoxicillin + sulbactam. Overall, the antibiotic against with high resistance found was ampicillin followed by cotrimoxazole, gentamicin, ceftazidime, norfloxacin, ciprofloxacin, tetracycline, levofloxacin, cefepime and least resistance to amikacin, netilmicin and nitrofurantoin. Conclusion Majority of UTIs in this study were caused by E. coli followed by Klebsiella pneumoniae. The high resistance was found with ampicillin (75%). Nitrofurantoin was the most commonly prescribed drug followed by other flouroquinolones.

2020 ◽  
Vol 75 (12) ◽  
pp. 3656-3664
Author(s):  
Rasmus Richelsen ◽  
Jesper Smit ◽  
Henrik Carl Schønheyder ◽  
Pavithra Laxsen Anru ◽  
Belen Gutiérrez-Gutiérrez ◽  
...  

Abstract Objectives To assess the impact of ESBL production on mortality and length of hospital stay (LOS) of community-onset infections due to Escherichia coli or Klebsiella pneumoniae. Methods A population-based cohort study including all adult patients hospitalized with a first-time community-onset E. coli or K. pneumoniae bacteraemia or urinary tract infection in the North Denmark Region between 2007 and 2017. For each bacterial agent, we computed 1 year Kaplan–Meier survival curves and cumulative incidence functions of LOS, and by use of Cox proportional hazard regression we computed HRs as estimates of 30 day and 1 year mortality rate ratios (MRRs) and LOS among patients with and without ESBL-producing infections. Results We included 24 518 cases (among 22350 unique patients), of whom 1018 (4.2%) were infected by an ESBL-producing bacterium. The 30 day cumulative mortality and adjusted MRR (aMRR) in patients with and without ESBL-producing isolates was as follows: E. coli bacteraemia (n = 3831), 15.8% versus 14.0%, aMRR = 1.01 (95% CI = 0.70–1.45); E. coli urinary tract infection (n = 17151), 9.5% versus 8.7%, aMRR = 0.97 (95% CI = 0.75–1.26); K. pneumoniae bacteraemia (n = 734), 0% versus 17.2%, aMRR = not applicable; and K. pneumoniae urinary tract infection (n = 2802), 13.8% versus 10.7%, aMRR = 1.13 (95% CI = 0.73–1.75). The 1 year aMRR remained roughly unchanged. ESBL-producing E. coli bacteraemia was associated with an increased LOS compared with non-ESBL production. Conclusions ESBL production was not associated with an increased short- or long-term mortality in community-onset infections due to E. coli or K. pneumoniae, yet ESBL-producing E. coli bacteraemia was associated with an increased LOS.


1970 ◽  
Vol 24 (1) ◽  
pp. 19-23 ◽  
Author(s):  
Taslima Taher Lina ◽  
Sabita Rezwana Rahman ◽  
Donald James Gomes

Antibiotic resistance in urinary tract infection (UTI) is a growing public health problem in the world. In this study, a total of 182 uropathogens were isolated from patients with symptoms of urinary tract infection (UTI). Escherichia coli (88%) was the most prevalent isolate, while Klebsiella pneumoniae was recovered from 12% cases. The male/female ratio was 1:3. About 56% female and 51% male patients belonged to the age group >40 years. The antibiotic resistance rates of the isolates to fifteen different drugs were investigated. E. coli and K. pneumoniae showed variable pattern of susceptibility. The percentage of resistance to different drugs was higher in E. coli isolates compared to that of K. pneumoniae. Among the total number of isolates about 87% were resistant to at least three commonly used antibiotics. All the isolates were sensitive to imipenem. Analysis of the plasmid DNA had shown that the plasmid pattern was very diverse in both E. coli and K. pneumoniae. All the isolates contained multiple numbers of plasmid ranging from 1.0 to >140 MDa. Middleranged plasmids (30 to 80 MDa), the transferable resistance plasmids, were found to be present in 86% E. coli and 85% K. pneumoniae isolates. The strong association observed between plasmid profiles and drug resistance patterns suggest that plasmids other than the common plasmids may have epidemiological significance. The presence of class 1 and class 2 integrons were also investigated. A relatively high occurrence of class 1 integrons, that are associated with lateral transfer of antibacterial resistance genes, was observed in K. pneumoniae (88%) than in E. coli isolates (54%). Class 2 integrons were not found in any of the E. coli and K. pneumoniae isolates. These results show the high rate of drug resistance and the presence of high rate of transferable elements in these MDR isolates. Keywords: Uropathogens, Escherichia coli, Klebsiella pneumoniae, Multidrug-resistant (MDR) bacteria, Plasmid profiles, IntegronsDOI: http://dx.doi.org/10.3329/bjm.v24i1.1231 Bangladesh J Microbiol, Volume 24, Number 1, June 2007, pp 19-23


Author(s):  
Mohamed Kettani Halabi ◽  
Fatima Azzahra Lahlou ◽  
Idrissa Diawara ◽  
Younes El Adouzi ◽  
Rabiaa Marnaoui ◽  
...  

Extended-spectrum β-lactamases producing Escherichia coli (ESBL-EC) lend resistance to most β-lactam antibiotics. Because of limited treatment options, ESBL-EC infections are generally more difficult to treat, leading to higher hospital costs, reduced rates of microbiological and clinical responses, and a threat to the patient’s life. This study aimed to determine the antibiotic resistance pattern of ESBL-EC isolated from patients with urinary tract infection in Morocco. This retrospective laboratory-based study was conducted at Cheikh Khalifa International University Hospital, Casablanca, from January 2016 to June 2019. A total of 670 urine samples were collected from urinary tract infection patients and processed by standard microbiological methods. In vitro susceptibility testing to different antibiotics of all identified isolates of Escherichia coli (E. coli) was performed following Kirby–Bauer’s disc diffusion method on Mueller–Hinton Agar according to the EUCAST standards. The reviewing of ESBL-EC was confirmed by the appearance of a characteristically shaped zone referred to as a “champagne cork” using the Combined Disk Test. Among a total of 438 E. coli isolated from nonrepetitive urine samples, two hundred fifty-nine (59%) were ESBL-EC, of which 200 (77%) were isolated from adult patients (over the age of 50) and the majority were female. All ESBL-EC isolates were resistant to third-generation cephalosporin and quinolones and sensitive to carbapenem and fosfomycin. Knowledge of antimicrobial resistance patterns in ESBL-EC, the major pathogen associated with urinary tract infection, is indispensable as a guide in choosing empirical antimicrobial treatment.


Author(s):  
Herdiyanti Herdiyanti ◽  
Lindawati Alimsardjono ◽  
Danti Nur Indiastuti

Introduction: Urinary tract infection (UTI) is an infection that involves the urinary tract, including the urethra, bladder, ureter, and kidneys. UTI is caused by microorganisms that breed in the urinary tract which are supposed to be free of microorganisms. Two bacterias that cause UTI in general are Escherichia coli and Klebsiella pneumoniae. UTI can occur at any age but generally occurs in the elderly. UTI caused by gram-negative bacteria can be killed with several examples of antibiotics namely amikacin, ceftazidime, meropenem and nitrofurantoin. These antibiotics found resistance to the bacteria that cause the UTI. This research is to determine the resistance patterns of Escherichia coli and Klebsiella pneumoniae bacteria against amikacin, ceftazidime, meropenem, nitrofurantoin antibiotics in elderly patients with UTI in Dr. Soetomo Surabaya January-June 2017 period.Methods: A descriptive retrospective study in accordance with the logbook data of Clinical Microbiology Installation at Dr. RSUD. Soetomo Surabaya. Data from this study were taken from all populations that met the inclusion criteria. The results are presented by tables. Results: There are 163 elderly patient data which diagnosed with urinary tract infection. Escherichia coli resistance pattern against ceftazidime (75.6%), nitrofurantoin (12.6%) and meropenem (2.4%). Meanwhile, Klebsiella pneumoniae against ceftazidime (72.2%), nitrofurantoin (55.6%), meropenem (11.1%) and amikacin (2.8%). Conclusion: There were resistance number of Escherichia coli and Klebsiella pneumoniae bacteria against antibiotics amikacin, ceftazidime, meropenem, nitrofurantoin in elderly patients with UTI.


2016 ◽  
Vol 42 (03) ◽  
pp. 143-148 ◽  
Author(s):  
Nan-Ling Kuan ◽  
Chia-Wei Chang ◽  
Chien-An Lee ◽  
Kuang-Sheng Yeh

Extended-spectrum [Formula: see text]-lactamase (ESBL)-producing microorganisms often cause severe infections; they have only limited therapeutic alternatives and have emerged in both human and veterinary medicine. Companion animals have prolonged contact with humans and could serve as a reservoir for ESBL strains. Information regarding ESBL producers in companion animals is rather limited compared to that regarding humans. Therefore, the objective of this study was to screen for ESBL producers in Escherichia coli, Klebsiella pneumoniae, and Proteus mirabilis in urine samples collected from dogs and cats in which urinary tract infection was suspected in a veterinary teaching hospital in Taipei, Taiwan. In addition, bla genes, multilocus sequence typing (MLST) analysis, and antibiotic susceptibility testing were performed on these ESBL producers. From December 2011 to March 2013, disc tests of cefotaxime and ceftazidime, with and without clavulanic acid, were performed on 60 E. coli, 22 [Formula: see text]. pneumoniae, and 18 P. mirabilis samples isolated from urine; 2 E. coli and 5 K. pneumoniae samples with the ESBL phenotype were identified. CTX-M-15 was the most frequently found bla gene. CTX-M-14, SHV-11, SHV-12, and SHV-28 were also identified. MLST analysis did not detect a predominant ST type in either E. coli or [Formula: see text]. pneumoniae; nonetheless, K. pneumoniae ST15 and ST11, which are zoonotic agents of public health concern, were detected in our study. All ESBL-producing bacteria exhibited a multidrug-resistant phenotype. The occurrence of ESBL-producing E. coli and K. pneumoniae in companion animals underscores the importance of ESBL screening and epidemiological study in veterinary hospitals.


Author(s):  
Nandkishor Bankar ◽  
Dhruba Hari Chandi ◽  
Praful Patil ◽  
Gaurav Mahajan

Introduction: UTI occurs when bacteria that live inside intestine find their way into the urinary tract through the urethra. Women are familiar to be a lot of at risk of UTI than men, with a five hundredth probability of a UTI in their life. Aim: The aim of this study was to find the antibiotic resistance pattern in Escherichia coli isolated from urinary tract infection with commonly found antibiotics among different age and sex groups. Materials and Methods: All positive urine samples for Escherichia coli obtained from patients were included. On the basis of colony morphology and biochemical tests Isolates were identified. The antibiogram profile of the isolates was determined by commonly used antibiotics. Result: In this studied, total 250 patients with UTI of both sexes were included and divided into age group. Samples processed only 250 samples with the growth of E. coli were included in this studied. The isolated E.coli showed more resistant to some degree to all the antibiotics tested.  The greatest resistance was shown against Amoxycillin (15.2% isolated were sensitive) and the least resistance was shown against Imipenem (96.4% isolated were sensitive). Conclusion: The pattern of antibiotic resistance varies from place to place, region to region, and country to country. Antimicrobial resistance should be monitored on a regular basis in both the community and hospital settings.


2018 ◽  
Vol 8 (2) ◽  
pp. 78-81 ◽  
Author(s):  
Mohsen Rajabnia ◽  
Mohammad Saad Forghani ◽  
Sabah Hasani ◽  
Mohammad Bahadoram ◽  
Mahsa Mohammadi ◽  
...  

Introduction: Urinary tract infection (UTI) due to extended spectrum beta-lactamase (ESBL)-producing bacteria including Escherichia coli has become widespread. Studies have shown a trend toward higher mortality, longer hospitalization, greater hospital expenses and reduced rates of clinical and microbiologic response in ESBL UTI. Objectives: The aim of this study is to determinate the prevalence and antibiotic resistance pattern of ESBL producing E. coli isolated from UTI. Patients and Methods: This cross-sectional study was conducted on 3126 samples. Urine specimens were cultured on Eosin Methylene Blue (EBM) and blood agar. The disk diffusion standard method (Kirby Bauer) was used to test the susceptibility of the drug on MullerHinton agar plates and results were reviewed based on Clinical and Laboratory Standards Institute (CLSI) criteria. The reviewing of ESBL-producing uropathogens was carried out using Combined Disk Test (CDT) by using cefotaxime (CTX; 30 µg) and cefotaximeclavulanic acid (CTX; 30 µg /CA:10 µg) disks and CLSI protocol. Results: Out of 291 E. coli isolates, 108 (37.11%) are ESBL-producer and 183 (62.89%) are non–ESBL-producer. Among ESBL-producing E. coli, the highest antibiotic resistance was observed with cefotaxime (100%), amoxicillin (97.22%) and piperacillin (96.3%) and the highest antibiotic sensitivity was observed with meropenem (93.5%), nitrofurantoin (81.48%) and gentamicin (55.56%). Conclusion: We recommended that cephalosporins, penicillins and cotrimoxazole are not suggested in the treatment of ESBL-producing E. coli. On the other hand, carbapenems as a first line and aminoglycosides as the next step in the treatment of ESBL-producing E. coli are recommended.


2003 ◽  
Vol 71 (6) ◽  
pp. 3088-3096 ◽  
Author(s):  
Peter Redford ◽  
Paula L. Roesch ◽  
Rodney A. Welch

ABSTRACT Extraintestinal Escherichia coli strains cause meningitis, sepsis, urinary tract infection, and other infections outside the bowel. We examined here extraintestinal E. coli strain CFT073 by differential fluorescence induction. Pools of CFT073 clones carrying a CFT073 genomic fragment library in a promoterless gfp vector were inoculated intraperitoneally into mice; bacteria were recovered by lavage 6 h later and then subjected to fluorescence-activated cell sorting. Eleven promoters were found to be active in the mouse but not in Luria-Bertani (LB) broth culture. Three are linked to genes for enterobactin, aerobactin, and yersiniabactin. Three others are linked to the metabolic genes metA, gltB, and sucA, and another was linked to iha, a possible adhesin. Three lie before open reading frames of unknown function. One promoter is associated with degS, an inner membrane protease. Mutants of the in vivo-induced loci were tested in competition with the wild type in mouse peritonitis. Of the mutants tested, only CFT073 degS was found to be attenuated in peritoneal and in urinary tract infection, with virulence restored by complementation. CFT073 degS shows growth similar to that of the wild type at 37°C but is impaired at 43°C or in 3% ethanol LB broth at 37°C. Compared to the wild type, the mutant shows similar serum survival, motility, hemolysis, erythrocyte agglutination, and tolerance to oxidative stress. It also has the same lipopolysaccharide appearance on a silver-stained gel. The basis for the virulence attenuation is unclear, but because DegS is needed for σE activity, our findings implicate σE and its regulon in E. coli extraintestinal pathogenesis.


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