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 ◽  
...  

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.

2020 ◽  
Vol 7 (1) ◽  
pp. 23-29
Author(s):  
Gunjal P. N. ◽  
Gunjal S. P.

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.


2019 ◽  
Vol 11 (03) ◽  
pp. 206-211
Author(s):  
Jaison Jayakaran ◽  
Nirupa Soundararajan ◽  
Priyadarshini Shanmugam

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.


2016 ◽  
Vol 5 (1) ◽  
pp. 20-23
Author(s):  
Raziur Rahman ◽  
Muhammad Abdur Rahim ◽  
Samira Rahat Afroze ◽  
Palash Mitra ◽  
Tabassum Samad ◽  
...  

Background and Aims: Urinary tract infection (UTI) is a common illness. The spectrum of bacteria causing UTI and their antibiotic sensitivity is not uniform. This study was designed to describe the bacteriological spectrum causing UTI and their antibiotic sensitivity.Methods: This cross-sectional study was done in the Department of Internal Medicine, BIRDEM General Hospital from January to June, 2013.Results: Total number of patients was 103 with females predominance (F:M ratio 2:1). Mean age was 57.5 years. Most (91.3%) of the study population were diabetic with poor glycaemic control (mean HbA1c 9.9%). Common symptoms were fever, dysuria, increased urinary frequency, suprapubic pain, vomiting and loin pain. Neutrophilic leukocytosis was common (94.2%). E. coli (79.6%) was the commonest aetiological agent followed by Klebsiella (9.7%), Citrobacter (3.9%), Acinetobacter (1.9%), Enterobacter (1.9%), Enterococcus (1.9%) and Pseudomonas (0.9%). Imipenem (100%), aminoglycosides e.g. amikacin and gentamycin and nitrofurantoin were among the most sensitive antibiotics.Conclusion: E. coli is the commonest organism causing UTI and imipenem, amikacin and nitrofurantoin are the most sensitive antibiotics.Birdem Med J 2015; 5(1): 20-23


2016 ◽  
Vol 5 (2) ◽  
pp. 51-55 ◽  
Author(s):  
Bigu Kumar Chaudhari ◽  
Ganesh Kumar Singh ◽  
Kamal Prasad Parajuli ◽  
Kewal Shrestha

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


Author(s):  
Imran Qureshi ◽  
Mirza Tasawer Baig ◽  
Uzma Shahid ◽  
Ambreen Huma ◽  
Aisha Jabeen ◽  
...  

Background: Medication prescribing errors were always known as inevitable errors in health care system which mainly includes physician’s writing error which then leads to wrong dispensing error. Manual Prescribing has now shifted to CPOE System that seems to be more efficient. Through this system, it is believed that quality and patient security is improved by lessening medicine and different mistakes at various phases of the request the board procedure and by maintaining a strategic reserve from repetitive testing. This Study was conducted to compare the prescribing errors in different hospital wards of a tertiary care hospital for in-patients by using two approaches; Manual Prescribing and CPOE System Prescribing. Methods: This cross sectional study was conducted on manual prescriptions for three months and on CPOE prescriptions for three months. In this way a total of 4102 prescriptions were evaluated for different types of prescribing errors occurred in different wards. Whole study was conducted on In-patients from all the wards in the hospital except Emergency and OPD patients. Results and Discussion: The results showed that the maximum number of manual prescription errors were found in Medical ICU ward, while prescribing errors for CPOE setup were found comparatively at higher rate in Medicinal ward. It was also found that maximum frequency of prescribing errors were found in Lower Respiratory Tract Infections in both the settings; CPOE System and Manual Prescribing Conclusion: It was concluded that CPOE system is helpful for reducing prescribing errors but it must be supervised by pharmacists to overcome potential errors.


Author(s):  
Bhavana Pandey ◽  
Devesh Kumar Shukla

Background: RTIs/STIs are a common public health problem in developing countries, contributing to a huge economic burden among individuals and health systems. RTI's excluding HIV constitutes the second major cause of disease burden (after maternity related causes) in women of developing countries. This cross sectional study is carried out with objectives of, to study socio-economic profile of respondents and to determine socio-economic factors of RTI, affecting the women of reproductive age group attending CIMS, Hospital Bilaspur (C.G.).Methods: A descriptive cross sectional study conducted in a tertiary care hospital CIMS, Bilaspur (Chhattisgarh) from May 2015 to October 2016. Total 450 cases were studied. Predesigned and pretested questionnaire was used to collect information regarding the socio-demographic profile and clinical profile of women’s regarding RTI. Statistical analysis was done using SPSS and Chi-square test was applied.Results: 4.3% (450) patient attending Obstetrics and Gynecology OPD were found to be suffering from RTI. Out of the 450 women, 83.8% of the women had experienced at least one symptom suggestive of RTI previously. Abnormal vaginal discharge was reported by 88.9% followed by lower abdominal pain (78.9%), genital ulcer (34%) and menstrual irregularity 75.8% of women. Symptoms of RTI were higher in old age, illiterate, those with employed, rural residential, Schedule tribe category, poor socio-economic status, separated, divorce and widow and women their husband educated up to primary class.Conclusions: Generating community awareness, ensuring proper menstrual hygiene, and improving the socioeconomic status would help in reducing the cases of RTI.


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