Background: Bacterial resistance to antibiotics is a growing public health threat worldwide. The increasing rate of antimicrobial resistance among bacterial pathogens causing both hospital- and community-acquired infections is a serious threat to public health world-wide. This inappropriate and non-judicious usage of antibiotics has resulted in the development of worldwide antibiotic resistance in bacteria, leading to the emergence of multi-resistant strains of bacterial pathogens. This study focuses on the prevalence of antibiotic resistance in the Enterobacteriaceae group of organisms in urine samples and also detects various methods of antibiotic resistance. Antibiotic resistance detection may be useful for epidemiological and research purposes, as well as for preventing the spread of drug-resistant organisms within hospitals through good infection control practices. Aims and Objectives: The aim of the study was to detect occurrence of β-lactamases, extended-spectrum beta-lactamases (ESBL) and Carbapenemase by phenotypic methods in Enterobacteriaceae from urine samples along with pattern of antibiotic resistance for various antibiotics in them. Materials and Methods: A descriptive study was conducted at a tertiary-care hospital. Testing of ESBL and carbapenemase production detection done according to CLSI (M100) guideline by the Kirby-Bauer disk diffusion method, combination disc diffusion test, and modified Carbapenem inactivation method. Results: A total of 220 Enterobacteriaceae organisms were isolated from processed urine samples of tertiary care Hospitals. Rate of cephalosporin resistance in ESBL and carbapenem-resistant Enterobacteriaceae (CRE) is more than 90% while in non-ESBL more than 70% and in non-CRE 75–80%. Carbapenem resistance in ESBL and non-ESBL is the same. Resistance to fluoroquinolone group, Aminoglycoside group, and Cotrimoxazole and Tetracycline group of antibiotics were more noticed in ESBL and carbapenemase producing organisms. In our study, fosfomycin and Nitrofurantoin are effective treatment in case of ESBL and CRE producing organism. Conclusion: The ESBL and Carbapenemase producing isolates were multi-drug resistant making therapeutic choices limited. Fosfomycin and Nitrofurantoin are effective treatment in multidrug resistance urinary tract infection.

Background: Urinary tract infection (UTI) is a common health problem in both community and nosocomial settings. However, the predisposing factors which are responsible for production of extended spectrum beta-lactamase (ESBL) and carbapenem-resistant Enterobacteriaceae makes the treatment option narrow and cause multidrug resistance. Aim and Objectives: This study demonstrate various risk factors associated with multidrug resistance in Enterobacteriaceae from UTI at tertiary care center in Gujarat. Material and Methods: A retrospective observational study was conducted at a tertiary-care hospital. Urine samples were received from various departments and outpatient department (OPD). Organisms from Enterobacteriaceae group were isolated and identified by various biochemical methods. ESBL and Carbapenemase producing organisms were then processed for Antibiotic susceptibility test as per CLSI guideline. Results: A total of 196 Enterobacteriaceae organisms were isolated from processed urine samples of tertiary care Hospitals. The most prevalent in people aged 45–65 years (36%) followed by those aged 17–30 (22%) years. UTI due to ESBL and Carbapenemase producer are more isolated in female (28%, 11%) as compare to male (16%, 6%). Indoor patients had higher prevalence of ESBL (29%) and carbapenemases (10%) isolation compare to OPD patient (ESBL-15%, Carbapenemases-7%) and among them most common ward was medicine department. The most common predisposing factor was catheterization followed by diabetes mellitus and obstructive uropathy. Discussion: High prevalence of ESBL and Carbapenemase producing Enterobacteriaceae is found in Indoor patients than OPD patients. Most of these patients are from Medicine department. Catheterization is the most common risk factor associated with ESBL and carbapenemase producing organism.