The decreasing effectiveness of antimicrobial agents is a global public health threat, yet risk factors for community-acquired antimicrobial resistance (CA-AMR) in low-income settings have not been clearly elucidated. Our aim was to identify risk factors for CA-AMR with extended-spectrum β-lactamase (ESBL)–producing organisms among urban-dwelling women in India. We collected microbiological and survey data in an observational study of primigravidae women in a public hospital in Hyderabad, India. We analyzed the data using multivariate logistic and linear regression and found that 7% of 1,836 women had bacteriuria; 48% of isolates were ESBL-producing organisms. Women in the bottom 50th percentile of income distribution were more likely to have bacteriuria (adjusted odds ratio 1.44, 95% CI 0.99–2.10) and significantly more likely to have bacteriuria with ESBL-producing organisms (adjusted odds ratio 2.04, 95% CI 1.17–3.54). Nonparametric analyses demonstrated a negative relationship between the prevalence of ESBL and income.

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Journal homepage: http://www.ijcmas.com Urinary Tract Infections (UTIs) are very common in clinical settings and many organisms are ground to be multi-drug resistant. Therefore, analyzing antibiotic susceptibility patterns will not only help in therapeutic difficulties but also decrease the indiscriminate use of antibiotics which are causing the development of MDR. Bacterial Isolates with a colony count of more than 10 5 /ml were included in the study. The uropathogens were isolated using Urochrome UTI agar and MacConkey agar. Identification was done by standard biochemical reactions and then subjected to antibiotic susceptibility testing against 18 antibiotics of different classes using Kirby-Bauer's disc diffusion method. Out of a total of n=4385 urine samples processed 974 (22.2%) were found to have significant bacteriuria and n=3413(77.8%) were found to be negative. Gram-negative bacteria were found to be 78.7% while gram-positive cocci accounted for the remaining 21.3 % of the total pathogens, E. coli (54%), Enterococcus spp (18%), K. pneumoniae (15%). Regular monitoring and surveillance is the need of the hour given the constantly rising drug resistance. It is necessary to make a local antibiogram about the hospital environment in discussion with the physicians to provide an updated and effective empirical treatment of UTIs.

BackgroundIrrational prescriptions have an ill effect on health as well as on healthcare expenditure. Prescription auditing is an important tool to improve the quality of prescriptions, which in turn improves the quality of health care provided. Regular and timely audits of antibiotic prescriptions can prevent irrational antibiotic usage. ConclusionBy judicious use of antibiotics, we can reduce the evolution of antibiotic resistance in bacteria and extend the useful life of antibiotics that are still effective. Antibiotic use patterns must be studied to address complications resulting from a large number of antibiotics.

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