scholarly journals Prevalence of ESBL Producing E. coli and Klebsiella Species in a Tertiary Care Hospital, Telangana

2020 ◽  
Vol 7 (38) ◽  
pp. 2116-2119
Author(s):  
Sofia Nawaz ◽  
Syeda Fahada Zia ◽  
Shashikala Reddy P,
Medicina ◽  
2019 ◽  
Vol 55 (7) ◽  
pp. 356 ◽  
Author(s):  
Gajdács ◽  
Ábrók ◽  
Lázár ◽  
Burián

Background and Objective: Urinary tract infections (UTIs) are common in human medicine, affecting large patient populations worldwide. The principal cause of UTIs is uropathogenic Escherichia coli (UPEC) and Klebsiella, both in community and nosocomial settings. The assessment of local data on prevalence and resistance is essential to evaluate trends over time and to reflect on the national situation, compared to international data, using the methods of analytical epidemiology. Materials and Methods: The aim of this study was to assess resistance trends and epidemiology of UTIs caused by E. coli and Klebsiella species in inpatients and outpatients at a tertiary-care hospital in Hungary, using microbiological data. To evaluate resistance trends, several antibiotics were chosen as indicator drugs, based on local utilization data. Results: E. coli was the most prevalent isolate, representing 56.75 ± 4.86% for outpatients and 42.29 ± 2.94% for inpatients. For E. coli, the ratio of resistant strains for several antibiotics was significantly higher in the inpatient group, while in Klebsiella, similar trends were only observed for gentamicin. Extended-spectrum β-lactamase (ESBL)-producing isolates were detected in 4.33–9.15% and 23.22–34.22% from outpatient, 8.85–38.97% and 10.89–36.06% from inpatient samples for E. coli and Klebsiella, respectively. Conclusions: Resistance developments in common UTI pathogens (especially to fosfomycin, sulfamethoxazole-trimethoprim, fluoroquinolones, and 3rd generation cephalosporins), seriously curb therapeutic options, especially in outpatient settings.


2021 ◽  
pp. 1-8
Author(s):  
Naimshree Sonkar ◽  
Malay Banerjee ◽  
Suman Gupta ◽  
Absar Ahmad

Introduction: Asymptomatic bacteriuria (ASB) is the presence of actively multiplying bacteria within the urinary tract with absence of any symptoms, resulting in adverse pregnancy outcomes. This research study was done in order to review prevalence, antimicrobial susceptibility profile, and factors associated with ASB occurring in female patients who are pregnant and being treated at a tertiary care hospital in Lucknow, India. Method and Materials: This is a cross-sectional study done among 216 pregnant women attending a hospital for antenatal check-ups. Clean catch midstream urine samples were collected and examined microscopically, and semi-quantitative culture was done on blood agar and MacConkey agar. Isolates were identified by colony morphology and biochemical tests, and antimicrobial susceptibility testing was done by using the Kirby-Bauer method. Results: Of the 216 pregnant women, 36 (16.7%) tested positive for ASB. The female gestational period, haemoglobin level, and BMI were significantly associated with ASB. Logistic regression also showed that higher haemoglobin level was less likely to ASB (AOR = 0.42, 95% confidence interval: 0.202–0.88, p = 0.021). The predominant and usual isolates were E. coli (n = 22, 61.1%), followed by Cons (n = 6, 16.7%), and S. aureus (3, 8.3%). All Gram-negative isolates were mostly sensitive to most of the drugs like piperacillin-tazobactam, cefepime, nitrofurantoin, and meropenem but were 100% resistant to ampicillin. Similarly, Gram-positive isolates were sensitive to ampicillin, vancomycin, linezolid, and nitrofurantoin but 100% resistant to co-trimoxazole. Conclusion: The present study shows the existence of ASB was 16.7% among women who are pregnant. Pregnancy duration, haemoglobin level, and BMI were significantly associated with ASB. The isolates identified more frequently were E. coli (61.16%), Cons (16.7%), and S. aureus (8.3%). All isolates which were Gram-negative were mostly sensitive to most of the drugs but were 100% resistant to ampicillin. Similarly, Gram-positive isolates were sensitive to most of the drugs but 100% resistant to co-trimoxazole.


Author(s):  
Vijayashree V. ◽  
Saikeerthana D. ◽  
Prabha P.

Background: The genus Klebsiella of Enterobacteriaceae family is ubiquitous in nature. They cause many nosocomial infections like pneumonia, urinary tract infections, wound infections, bacteremia and septicemia. Multidrug resistance is seen in Klebsiella which serves as the most common cause of increased morbidity and mortality. This study reveals the prevalence and antibiotic sensitivity pattern of Klebsiella species from various clinical samples. The primary objectives are as follows: To isolate and characterize Klebsiella species from various clinical samples. To study the antibiotic susceptibility pattern of Klebsiella isolates.Methods: This prospective study was conducted in our tertiary care hospital during the period from August 2019 to October 2019. A total of 3521 samples were tested during this period. The samples include blood, sputum, urine, and pus.Results: Out of the total samples tested,1106 samples were showing the growth of the organisms. Among this,351 were identified as Klebsiella species and the highest rate of isolation of Klebsiella species is from the sputum sample and also the same was reported high in medical wards. The study also shows that the isolation of Klebsiella species shows male preponderance when compared to females. The antibiotic sensitivity pattern was done by Kirby-Bauer's disc diffusion method and the sensitivity was noted to be higher to amikacin and ciprofloxacin.Conclusions: Thus, this study shows the prevalence rate of Klebsiella species and sensitivity pattern of Klebsiella, which may help select appropriate antibiotics and prevent overuse and misuse of antibiotics.


2018 ◽  
Vol 30 (2) ◽  
pp. 61-66
Author(s):  
Md Mahbubur Rahman ◽  
Osul Ahmed Chowdhury ◽  
Md Moynul Hoque ◽  
Syed Anwarul Hoque ◽  
Sultana Mehnaz Rahman Chowdhury ◽  
...  

The rapid emergence of antimicrobial resistance in major uropathogens has created a global threat especially in the developing countries. In Bangladesh, prescribers of different regions generally diagnose microbial infection on clinical judgment and select antimicrobial on empirical basis, which unfavorably affects the sensitivity pattern of microbes. The present study was designed to determine the prevalence of antimicrobial resistance of Escherichia coli and Klebsiella species isolated from patients with UTI in a tertiary care hospital. This was a cross sectional study conducted at Sylhet MAG Osmani Medical College Hospital, Sylhet from 1st January to 31st December 2016. A total of 200 clinically suspected urinary tract infection patients aged 16-85 years were included in this study. The isolated Escherichia coli and Klebsiella species were tested for antimicrobial susceptibility according to the guideline of Clinical and Laboratory Standards Institute (CLSI) 2011 using the modified Kirby- Bauer disc diffusion technique. Out of 107 pus cell positive ( 05/HPF) urine samples, 75 (70.1%) yielded significant bacteriuria of which 49 (65.3%) were Escherichia coli and 9 (12%) were Klebsiella species. The isolated Escherichia coli showed absolutely high resistance to ampicillin and cefuroxime (100%), moderately high resistance to ceftazidime (81.6%), ciprofloxacin (77.6%), cotrimoxazole (75.5%), cefotaxime (67.4%) and ceftriaxone (59.2%), moderate rate of resistance to amikacin 48.9% and imipenem 46.9% and least rate of resistance to gentamicin (22.5%), nitrofurantion (22.5%) and netilmicin (6.1%). In addition, Klebsiella species revealed completely resistance to ampicillin, cotrimoxazole, cefuroxime, cefotaxime, ceftriaxone, ceftazidime (100%), moderately high resistance to imipenem (88.9%), nitrofurantoin (77.8%), moderate resistance to ciprofloxacin (44.4%), amikacin (33.3%) and gentamicin (33.3%) and least resistance to netilmicin (11.1%). Hence very high resistance rates of 1st line drugs found in uropathigenic Escherichia coli & Klebsiella species, it is necessary to diagnose clinically followed by culture and sensitivity testing. Regular antibiotic surveillance of a particular geographical area is required to establish reliable information regarding susceptibility pattern of uropathogens in order to preserve the continued usefulness of most antimicrobial agents.Medicine Today 2018 Vol.30(2): 61-66


2016 ◽  
Vol 145 (3) ◽  
pp. 595-599 ◽  
Author(s):  
D. VUBIL ◽  
R. FIGUEIREDO ◽  
T. REIS ◽  
C. CANHA ◽  
L. BOAVENTURA ◽  
...  

SUMMARYTo date, only a few sporadic cases of infections due toKlebsiella pneumoniaecarbapenemase (KPC) producers have been reported in Portugal. Here, we report for the first time an outbreak ofK. pneumoniaeKPC-3 producers in a tertiary-care hospital during 2013. Twenty-seven ertapenem-resistantK. pneumoniaewere identified in patients at a tertiary-care hospital during 2013 isolated predominantly from urine (48·1%) and blood (25·9%) cultures. All isolates were highly resistant toβ-lactam antibiotics and most showed intermediate resistance to imipenem. The more frequentβ-lactamases were TEM- (77·7%), CTX-M- (70·3%) and KPC-type (66·6%). KPC-3 was identified by sequencing. TheblaKPC−3gene was associated with an IncF plasmid, and efficiently transferred toE. coliJ53. Pulsed-field gel electrophoresis typing revealed three clusters of isolates which were further characterized by multi-locus sequence typing as ST11, ST15 and ST348. Ertapenem-resistant ST15 was already in circulation in the hospital, related to expression of OmpK36 modified porin, but the other two sequence types had not been previously found in the hospital. We conclude that the IncF plasmid mediated transfer of KPC-3 in the outbreak and that implementation of carbapenemase gene screening in isolates from patients on admission to hospital is advisable in order to control dissemination of these antimicrobial resistance elements.


2020 ◽  
Vol 27 (02) ◽  
pp. 335-340
Author(s):  
Salman Azhar ◽  
Muhmmad Wasif Baig ◽  
Shahid Rasool ◽  
Rizwan Rasool Khan ◽  
Talha Munir ◽  
...  

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.


2017 ◽  
Vol 4 (6) ◽  
pp. 2103
Author(s):  
Rekha Thaddanee ◽  
Gurudas Khilnani ◽  
Nupur Shah ◽  
Ajeet Kumar Khilnani

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.


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