scholarly journals Emerging antibiotic resistance pattern of urinary tract infection (UTI) due to Escherichia Coli (E.Coli).

2021 ◽  
Vol 28 (12) ◽  
pp. 1804-1811
Author(s):  
Salman Azhar ◽  
Talha Munir ◽  
Mian Sajjad Ahmed ◽  
Wasif Baig ◽  
Ahmed Nawaz Baber ◽  
...  

Objective: To determine the emerging antibiotic resistance pattern of adult patients of MDR UTI cases caused by E.Coli. Study Design: Retrospective Data. Setting: Departments of Medicine and Obstetrics & Gynecology, Madinah Teaching Hospital / University Medical and Dental College, Faisalabad. Period: August 2016 to Sep 2018. Material & Methods: This retrospective study included 187 patients meeting the operational definition of multi-drug resistance cases of urinary tract infection caused by E. coli. All cases either male or female of age above 15 years with positive reports of urine culture and sensitivity for E.coli were included in the study. Along with the demographic variables urine WBC’s, results of urine culture and sensitivity were noted. Antibiotic sensitivity pattern of all the E.coli resistant UTI cases was analyzed. After identification of the microbe, antimicrobial sensitivity was accessed using Kirby–Bauer disc diffusion method on the Mueller–Hinton agar. The antimicrobial susceptibility test was performed against E. coli strains by using the following antibiotics: Piperacilin, Amoxicilin-Calvulanic, Pipmedic Acid, Cefipime, Ceftrixone, Cefuroxime, Cefoperazone-sulbactam, Ceftazidime, Cephradine, Ciprofloxacin, Ofloxacin, Levofloxacin, ofloxacin, Nitrofurantoin, Amikacin, Tombramycin, Gentamicin, Linezolid, Doxycycline, Sulphamethoxazole, Imipenem, Meropenem, Aztreonam in order to obtain an antibiogram. Results: In our data, 66.8% (n=125) were MDR UTI, and more than half of these cases were 63.2% (n=79) were females. Among the total 187 cases, 97.3% patients were resistant to most of the beta-lactam antibiotics, 95.7% were resistant to most of the quinolones and 68.4% were resistant to most of the aminoglycosides. Conclusion: This increasing antibiotic resistance is very alarming and steps should be taken to reduce the misuse of antibiotics. Studies should be done to control the risk factors leading to E. coli UTI. By following proper pharmacological guidelines, principles to use antibiotics and manage outpatient cases of UTIs, the incidence of MDR UTI can be controlled.

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):  
Shahida Akhter ◽  
A. S. M. Rizwan

Introduction: Urinary tract infection is one of the common community and nosocomial problem that we encounter at a daily basis. The mounting problem of emergence of resistant strains of bacteria causing urinary tract infection (UTI) is a great concern. We had tried in this study to outline the local pattern of antibiotic resistance of the commonly found uropathogens. Materials and Methods: This descriptive study was carried out in the Ad-din Sakina Women’s Medical College Hospital, Jashore, Bangladesh on patients attending inpatient Department from January to December 2020. Presence of more than or equal to 105 colony forming units/ml in urine culture was considered as significant for UTI. Isolated bacteria were tested by disk diffusion method. Results: Out of 1170 urine sample tested, 372 (31.8%) were found to be culture positive cases. A clear female preponderance (77.15%) was noted in positive culture rate. E. coli was the commonest organism found among all isolates (82.25%) followed by enterococci (4.3%), klebsiella (3.76%), pseudomonas (2.95%), proteus (2.68%), enterobacter (2.15%) and Staphylococcus aureus (1.88%). High resistance was noted in E. coli isolates against nalidixic acid (77%), Cefuroxime (75%), azithromycine (61%), cefotaxime (58%) and ceftazidime (54%). The antibiotic which showed least resistance overall includes imipenem, meropenem, nitrofurantoin and gentamicin. Conclusions: Antibiotic stewardship in accordance to local resistance and sensitivity pattern of uropathogens is mandatory to prevent the development of multidrug resistant strains. 


Author(s):  
Rupa Devi Mallam ◽  
Usha Kiran P.

Background: Urinary tract infection (UTI) is one of the most common diseases caused by bacteria in communities and hospital settings. With the irrational prescription of antibiotics and their misuse leads to constant increase in resistance. This study aims to evaluate the spectrum and antibiotic resistance pattern of uropathogens and to provide a basis for appropriate antimicrobial therapy in patients with UTI.Methods: A retrospective observational study was carried out for a period of 6 months from April 2018 to September 2018 at general hospital Kakinada. Data of 282 positive urine culture reports and their antibiotic susceptibility test results were collected from the records of the Microbiology department and were analyzed and depicted in percentages. Sample processing, identification of organisms, and pattern of antimicrobial sensitivity were carried out as per the Clinical and Laboratory Standards Institute guidelines.Results: Out of 282 positive reports, Escherichia coli was the most common isolated uropathogen with a total of 148 (52.4%) followed by Klebsiella 72 (26%), 20 (7.9%) each of Citrobacter and pseudomonas aeruginosa. E. coli were resistant to nalidixic acid (59.5%), cotrimoxazole (58.1%), ciprofloxacin (54%) amoxyclav (52.7%), ampicilin (45.9%), cefatoxime (37.8%), cefaperazone and salbactum (25.3%). Klebsiella were resistant to amoxyclav (77.7%), cotrimazole (50%), nalidixic acid (41.6%), ampicilin (44.4%), cefatoxime (27.7%), ciprofloxacin (25%). E. coli and Klebsiella were highly susceptible to nitrofurantoin, cefaperazone and salbactum, piperacillin and tazobactum, amikacin, imipenem, gentamicin.Conclusions: The majority of the isolated bacteria were resistant to many antibiotics commonly used in clinical practices. So prior culture reports and institutional antibiograms are necessary for prescribing antibiotics rationally.


Author(s):  
Shanthi Bamukumar ◽  
Kannan I ◽  
Sukumar Rg

  Objective: The aim is to study the fluoroquinolone resistance pattern among the pathogens causing urinary tract infection (UTI).Methods: This study was done during January to July 2016 in Tagore Medical College including both hospitalized and out patients. During this 7-month study, around 2695 urine samples were analyzed for the evidence of UTI. 718 samples were culture positive. 366 samples showed fluoroquinolones resistance (50.9%). They were screened for all fluoroquinolone drugs by doing antimicrobial susceptibility testing by Kirby-Bauer disc diffusion method as per the Clinical and Laboratory Standards Institute CLSI guidelines.Results: The resistance pattern of different isolates to norfloxacin is Klebsiella pneumoniae - 20%, Escherichia coli - 51.4%, Enterococci - 11.1%, Proteus mirabilis - 50%, and Staphylococcus saprophyticus - 37.5%; For nalidixic acid is K pneumoniae - 25%, E. coli - 6.8%, Pseudomonas aeruginosa - 71.4%, Enterococci - 11.1%, P. mirabilis - 25%, and S. saprophyticus - 25%; For ciprofloxacin is K. pneumoniae - 5%, E. coli - 5.4%, P. mirabilis - 25%, and S. saprophyticus - 25%; and For ofloxacin is K. pneumoniae - 10%, E. coli - 5.4%, Enterococci 11.1%, and S. saprophyticus 62.5%.Conclusion: Due to increasing resistance to fluoroquinolones in many hospitals and to make the developing resistance rates under control, empirical usage of it is either abandoned or should be restricted.


2019 ◽  
Vol 9 (4) ◽  
pp. 18-23
Author(s):  
Arun Sedhain ◽  
Abja Sapkota ◽  
Bidhan Shrestha

Background: Urinary tract infection (UTI) is characterized by pathological invasion of the urinary tract by microorganisms. Majorities of organisms causing UTI are gram negative bacteria, most common of which is E. coli. Urine culture and sensitivity test is used to isolate the organism and to identify the susceptible drug of choice for appropriate treatment. This hospital-based study was carried out to analyze the spectrum and antibiotic susceptibility of microorganisms causing UTI. Methods: A retrospective study was done to analyze the results of urine culture and sensitivity test done at Chitwan Medical College Teaching Hospital over a period of two and half years. Standard guideline and protocol were used to collect the urine sample and to perform the test. Data analysis was done using SPSS version 21.0. Result: Out of 12, 925 urine samples submitted for culture and sensitivity test during the study period, bacterial pathogens were isolated from 3, 173 (24.54%) samples, which was significantly higher among females (28%) than the males (17%). The most common organism isolated on the culture was E. coli (68.5%) followed by Klebsiella (18.4%). Sensitivity of the uropathogens was seen highest with colistin (79.2%) followed by teicoplanin (64.58%), Aztreonam (63.25%) and Ni­trofurantoin (61.16%). Most common antibiotics that showed resistance to the microorganisms in this study were Ampicillin (60.93%), Cotrimoxazole (53.72%), Cefixime (40.57%) and Levofloxacin (32.93%). Conclusions: This study has found a usual pattern of UTI with higher prevalence among females and E. coli being the most common organism. Nitrofurantoin has been found to have a good sus­ceptibility for the treatment of UTI.


Author(s):  
Nasrin Bahmani ◽  
Noshin Abdolmaleki ◽  
Afshin Bahmani

Background and Objectives: Urinary tract infection (UTI) is one of the most frequent infectious diseases which is caused by Gram-negative bacteria especially Escherichia coli. Multiple resistance to antimicrobial agents are increasing quickly in E. coli isolates and may complicate therapeutic strategies for UTI. The propose of this study was to determine the antibiotic resistance patterns and the multidrug-resistance (MDR) phenotypes in uropathogenic E. coli (UPEC). Materials and Methods: A total of 153 UPEC isolates were collected from both hospitalized patients (95 isolates) and outpatients (58 isolates) from March to October 2018. In order to determine the MDR among UPEC isolates, we have tested 15 antimicrobial agents on Muller Hinton agar by the disk diffusion method. Results: The percentage of MDR isolates (resistant to at least three drug classes such as fluoroquinolones, penicillins and cephalosporins) was 55.5% in the hospitalized patients and the outpatients. Antibiotic resistance to ampicillin, ceftazidime, nalidixic acid and trimethoprim/ sulfamethoxazole was higher than 60%. Meropenem, Imipenem and norfloxacin indicated markedly greater activity (93.3%, 80% and 85.6%, respectively) than other antimicrobial agents. Conclusions: Urinary tract infection due to MDR E. coli may be difficult to treat empirically due to high resistance to commonly used antibiotics, so, empirical antibiotic treatment should be reviewed periodically at local studies.


Author(s):  
Vismaya V. R. ◽  
Naiema Shajihan ◽  
Midhun Ramesh ◽  
Ambika Devi

Urinary tract infection (UTI), of varying severity is one of the most commonly encountered ailments in nephrology outpatient department (OPD). The commonest pathogens causing community acquired UTI (CAUTI) are E. Coli, Proteus mirabilis, Pseudomonas aeruginosa and Klebsiella pneumonia. There is a rapidly rising trend of antibiotic resistance among these uropathogens, may be due to indiscriminate antibiotic usage and poor patient compliance. We conducted a retrospective analysis of all culture proven UTI cases that attended the nephrology OPD of S. K. hospital, Trivandrum from August 2017 to July 2019 (24 months). 130 males and 121 females were included in the study. The mean age of the study group was 62.8 years with a male predominance in the age group above 50 years and a female predisposition in less than 50 years group. Commonest pathogen isolated in urine culture was E. coli (52.98%) followed by Klebsiella (39.09%), Citrobacter (8.76%), Pseudomonas (8.37%), Enterobacter (2.39%), Enterococci (1.99%), Candida (1.59%), Acinetobacter (1.2%), Proteus (1.2%), Streptococci (1.2%) and Serratia (0.4%).


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