Antibiotic Resistance to Escherichia coli among Urine Culture-Positive Patients in a Tertiary Care Hospital in Nepal: A Descriptive Cross-sectional Study

Abstract

Introduction: Urinary tract infection is treated by the antibiotic sensitivity pattern of uropathogensin our population. Present infection cases have been showing an increase in resistance to the currentfirst-line of antibiotics. The objective of this study is to determine the resistance of antibiotics inEscherichia coli in a tertiary care center.
 Methods: This is a descriptive cross-sectional study done in Kathmandu Medical College TeachingHospital from October 2018 to February 2019. The sample size was calculated, and convenientsampling was done. Patients with urine culture positive (i.e., Colony-forming unit >105) wereincluded in the study. All positive samples were tested for antibiotics sensitivity and resistance. Theresistance to the antibiotics was recorded using Statistical Package for Social Sciences version 20.Point estimate at 95% confidence interval was calculated along with frequency and proportion forbinary data.
 Results: Out of 100 samples, the highest number of organisms isolated was Escherichia coli, 71 (71%).Escherichia coli showed the highest resistance to drugs like Norfloxacin, 37 (52.11%), AmoxicillinClavulanic acid 37 (52.11%), followed by Co-trimoxazole 32 (45.1%), Ceftriaxone, 24 (33.8%), andCiprofloxacin 23 (32.3%).
 Conclusions: Escherichia coli showed the highest resistance to commonly used antibiotics likeNorfloxacin, Amoxicillin-Clavulanic acid, Co-trimoxazole, Ceftriaxone, and Ciprofloxacin.

Identification of metallo-β-lactamases and AmpC production among Escherichia coli strains isolated from hemodialysis patients with urinary tract infection

“…Of the three aminoglycosides studied here, AMK showed the highest efficacy compared to GEN and TOB, supporting previous studies from USA [ 24 ] and Gabon [ 30 ]. However, a survey by Kushwaha et al [ 31 ] from Nepal showed an opposite result: GEN had higher efficacy against UTI-inducing E . coli isolates than AMK and TOB.…”

Prevalence, antibiotic resistance pattern for bacteriuria from patients with urinary tract infections

“…3,6,7,41,59 The anatomical structure of women, such as the shorter urethra, being very close to the vagina and anal orifice, hormonal changes during the menopausal period, during sexual intercourse receiving bacteria from their partner, use of contraceptive materials, and involvement in sexual activities using both the vagina and anal orifice, might be the potential reasons for the higher prevalence of UTIs in female patients. 3,60 In addition, during pregnancy, numerous hormonal and mechanical changes in the body, glycosuria, aminoaciduria, and urine retention in the bladder contribute to a higher prevalence of UTIs in female patients. Thus, females are more susceptible to UTIs than males, as highlighted in the present study data.…”

Prescription pattern of antibiotics in urinary tract infection based on antimicrobial susceptibility test at a tertiary care hospital

“…These antibiotic susceptibility tests were consistent with prior studies. [19][20][21] This highlights the importance of conducting antibiotic susceptibility tests before prescribing treatment to ensure the appropriate choices of antibiotics.…”