Adherence to Hospital Antibiotic Policy for Treatment of Escherichia coli ESBL in Urine

Someshwaran, R.; Kg, Prakash; Sa, Deshpande; An, Aravazhi

doi:10.7860/jcdr/2016/16084.7382

Cited by 3 publications

(5 citation statements)

References 20 publications

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“…(1.5%). (Table 1) E.coli being the most common uropathogen to cause UTI has been supported by various studies [20][21][22] . In a study done in Nepal, among 237 isolates, the least common organism responsible for UTI in the in-patients was S. aureus 14 .…”

Section: Fig3: Obstetrics History Of Patientsmentioning

confidence: 77%

Untitled

2016

IJPSR

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The study was aimed to investigate the common causative agents of urinary tract infection in community, their resistance pattern to different antibiotics, and the prescribing patterns of antibiotics used for treatment. A total of 200 women attending gynaecology OPD of Tribhuvan University teaching hospital had their urine tested for culture and sensitivity, out of which 85 showed microbial growths. Escherichia coli (56.9%) and Staphylococcus aureus (27.7%) were the most common organisms isolated. E.coli was found to be resistant against ampicillin (72.7%), followed bycephalexin (59.3%), cotrimoxazole (45.2%), cefixime (40%), ceftriaxone (26.3%), norfloxacin (25.9), ciprofloxacin (25%), ofloxacin (20.7%) nitrofurantoin(9.7%), gentamycin (9.4%) and amikacin (8%). S.aureus was found to be resistant against cefixime (71.4%), followed by ampicillin (64.7%), ciprofloxacin (60%), cotrimoxazole (35.7%), ofloxacin (33.3%), norfloxacin (33.3%), cephalexin (23.5%), cloxacillin (17.6%), gentamycin (8.3%) and nitrofurantoin (5.9%). Out of 65 patients, 48 were treated with definite antibiotic therapy and 17 were treated with empirical antibiotics. The antibiotics used in definite therapy were nitrofurantoin (36.7%), ofloxacin (20.4%), cephalexin (10.2%), norfloxacin (8.2%), ciprofloxacin (8.2%), cloxacillin (4.1%), cefixime (4.1%), ampicillin (4.1%), amikacin (2%) and levofloxacin (2%). The antibiotics used in empirical treatment were nitrofuran to in (35.2%), ofloxacin (29.4%), cefixime (11.7%), norfloxacin (11.7%), amoxicillin (5.8%), and levofloxacin (5.8%). INTRODUCTION: Urinary tract infection (UTI) is the most common bacterial infection encountered in general medical practice 1, 2. UTI is defined as the multiplication of organisms in the urinary tract. It is usually associated with the presence of neutrophils and >10 5 organisms in a midstream (MSU) 3. The organisms causing UTI in the community are E. coli (over 70% infections), Proteus, Pseudomonas species, Streptococci, Staphyllococcus 4, 5 .

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Section: Fig3: Obstetrics History Of Patientsmentioning

confidence: 77%

Untitled

2016

IJPSR

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“…The co-existing of ESBL and fluoroquinolone resistant is extremely high in some areas of the world, in those who uses quinolones prophylaxis and in returned travelers to theses endemic areas [73]. Therefore, they are in general not recommended in the setting of high ESBL isolates [74].…”

Section: Fluoroquinolonesmentioning

confidence: 99%

Resistant Gram-Negative Urinary Tract Bacterial Infections

Hamza¹,

Khalil²

2018

Urinary Tract Infection - The Result of the Strength of the Pathogen, or the Weakness of the Host

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Urinary tract infection (UTI) is one of the most common infections in both the community as well in hospital settings. It is mostly caused by Gram-negative bacteria (GNBs). Over the past two decades, GNBs have developed complex mechanisms of resistance against most of the potent antibiotics. This has been a global challenge which has been identified by the World Health Organization as "one of the greatest threats to human health." This crisis is mostly attributed to the overuse and misuse of these medications, as well as lack of new drug antimicrobials by the pharmaceutical industry. This resulted in prolonged hospital stay, marked increase in the cost as well as increase in morbidity and mortality. Furthermore, it increases the risks and complications of urological procedures. In this chapter, we review the management of the most common and challenging group of resistant Gram-negative organisms, the extended-spectrum β-lactamases producing organisms (ESBL) and the carbapenem-resistant organisms (CRE/CRP). The latter group includes carbapenem-resistant Enterobacteriaceae (CRE), as well as Pseudomonas aeruginosa carbapenemases (CRP). When treating these infections, clinicians have few effective antimicrobials options. A critical step in managing these organisms is the early recognition and appropriate empiric therapy. Both showed morbidity and mortality benefits.

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“…[12,13] Most of these bacteria have now developed resistance to the β-lactam drugs by producing Extended Spectrum β-Lactamase (ESBL) enzymes. [18] There has been an increase in the resistance towards fluoroquinolones, trimethoprim and cephalosporins among urinary tract infection cases in recent years, which is quite worrisome. There is increased prevalence of E. coli strains producing extended spectrum -lactamase, Amp C and Metallo--lactamase, making the clinical management even more difficult in hospitalized patients.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…[18] Production of ESBL enzymes in E.coli may be a risk factor for development of resistance towards Carbapenemase in near future. [18] A recent study done by Sekar et al in 2016 regarding prevalence of E.coli and Klebsiella in rural South India shows that prevalence of aztreonam and fluoroquinolone resistance was very high in E. coli. [21] Another study done by Maheshwari et al (2016) revealed a potential health threat due to common presence of ciprofloxacin resistant ESBL producing enteric bacteria (mainly E.coli) in hospital waste water and clinical sources.…”

Section: Introductionmentioning

confidence: 99%

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