<p>Changing antibiotic susceptibility pattern in uropathogenic <em>Escherichia coli</em> over a period of 5 years in a tertiary care center</p>

Abstract

Objective: To assess the changing antibiotic sensitivity pattern in Uropathogenic E. coli over a period of time (2013–2017) with a special emphasis on ESBL-producing E. coli. Methods: This retrospective study was carried out in the Department of Microbiology, Kasturba Medical College, Ambedkar Circle, Mangalore. A retrospective time bound analysis of 500 samples/year was performed. The urine samples received from the suspected cases of urinary tract infection (UTI) were processed. Wet mount examinations of urine samples were done. The urine culture was done by a semi-quantitative method on Mac Conkey’s agar, Cysteine Lactose Electrolyte Deficient (CLED) medium, and UTI Chrome agar. Culture plates were incubated for 18–24 hours at 37°C. Urine samples with a colony count of ≥10 5 CFU/ml were considered significant. The uropathogens were identified by their biochemical reactions. The antibiotic susceptibility testing (AST) was carried out using a Vitek Compact 2 system and Modified Kirby Bauer disc diffusion method. Results: Antibiotic resistance of Uropathogenic E.coli to cephalosporins increased from 51 to 58%, Cotrimoxazole: 52 to 59%, Piperacillin tazobactam 9.4 to 23%, Carbapenems 0 to 5.9%. Antibiotic resistance to netilmicin has reduced from 8 to 6.5%, and norfloxacin 59 to 48%. The rates of ESBL production have increased from 45.2 to 59.6% in the 5 years. Conclusion: The increasing antibiotic resistance trends in UTI patients indicate that it is vitally important to use them conservatively. Proper guidelines, management of antibiotic usage, and constant information to the clinicians regarding the sensitivity pattern can help to prevent drug resistance.

Antimicrobial Resistance Among Uropathogens: Surveillance Report From South India

“…Patwardhan et al had earlier reported a significant increase in AMR in North India over a period of five years [ 26 ]. In a study from another part of South India by Prasada et al over five years on E. coli infections, there was a significant increase in resistance for quinolones and piperacillin-tazobactam [ 27 ]. The study also showed a significant increase in the prevalence of ESBL producers over the study period (45% in 2013 to 60% in 2017).…”

<p>A Retrospective Analysis of Risk Factors and Patient Outcomes of Bloodstream Infection with Extended-Spectrum β-Lactamase-Producing <em>Escherichia coli</em> in a Chinese Tertiary Hospital</p>

“… 19 , 20 In recent years, antibiotic-resistant E. coli in urinary tract infections is increasing, predominantly ESBL-EC. 21 Therefore, we need to be highly vigilant for serious bloodstream infections caused by urinary tract infection bacteria entering the bloodstream.…”

<p>Eight-Year Surveillance of Uropathogenic <em>Escherichia coli</em> in Southwest China</p>

“…In England, the nonsusceptibility to third-generation cephalosporins for UPEC from hospital specimens from 6.3% in 2010 to 7.4% in 2013. 7 In Canadian, multidrugresistant (MDR) phenotypes of UPEC from outpatients increased from 9.7% in 2007 to 16.5% in 2016. 8 We present AMR data from routine laboratory-based surveillance of UPEC isolates in Southwest China for the period 2012-2019.…”