Prevalence of multidrug resistant bacteria in causing community acquired urinary tract infection among the patients attending outpatient department of Seti Zonal Hospital, Dhangadi, Nepal

Awasthi, Tek Raj; Pant, Narayan Dutt; Dahal, Puspa Raj

doi:10.3126/njb.v3i1.14232

Cited by 25 publications

(39 citation statements)

References 9 publications

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“…Antimicrobial resistance has become a serious global public health issue. Infections caused by drug resistant bacteria are responsible for increased morbidity and mortality [ 25 ]. The selection of the antibiotics for treatment of the bacterial infections should be based on culture and sensitivity reports.…”

Section: Discussionmentioning

confidence: 99%

Correlation between biofilm formation and resistance toward different commonly used antibiotics along with extended spectrum beta lactamase production in uropathogenic Escherichia coli isolated from the patients suspected of urinary tract infections visiting Shree Birendra Hospital, Chhauni, Kathmandu, Nepal

Neupane

Pant

Khatiwada

et al. 2016

Antimicrob Resist Infect Control

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114

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BackgroundEscherichia coli is the most predominant causative agent of urinary tract infection (UTI). Recently, increase in drug resistance among the uropathogenic bacteria has caused great problem in treatment of UTI. The main objective of this research is to determine the correlation between biofilm formation and resistance toward different commonly used antibiotics along with extended spectrum beta lactamase production in uropathogenic Escherichia coli.MethodsThe urine samples collected from the patients suspected of urinary tract infections (visiting Shree Birendra Hospital, Chhauni, Kathmandu, Nepal between July to December 2013) were cultured in cystine lactose electrolyte deficient (CLED) agar by using semi quantitative culture technique. Extended spectrum beta lactamase (ESBL) production was detected by combined disc diffusion technique and biofilm formation was detected by Congo red agar method. Chi-square test was applied and p-value < 0.05 was considered statistically significant.ResultsOut of 1480 urine samples, E. Coli was isolated from 208 (14.1 %) samples. Of total 69 (33.2 %) ESBL producing uropathogenic strains of E. coli, 20 (29 %) were strong biofilm producers, 22 (31.9 %) were moderate biofilm producers, 11 (15.9 %) were weak biofilm producers and 16 (23.2 %) were biofilm non producers. Whereas among 139 ESBL non producing E. coli, 22 (15.8 %) were strong biofilm producers, 20 (14.4 %) were moderate biofilm producers, 13 (9.4 %) were weak biofilm producers and 84 (60.4 %) were biofilm non producers. Among total 108 biofilm producing E. coli, maximum resistance was observed toward cephalexin followed by amoxicillin and highest susceptibility was seen toward amikacin.ConclusionThe ability of biofilm formation was found to be significantly higher in ESBL producing strains of E. coli than that in ESBL non producing strains (p < 0.05). There was higher resistance rate to antimicrobial agents among biofilm producing strains of E. coli than that in biofilm non producing strains. According to our antimicrobial susceptibility pattern for E. coli, to start preliminary treatment for UTI in Nepal, we recommend to use amikacin or nitrofurantoin. Further, for the treatment of the UTI, the antibiotics should be selected on the basis of the urine culture and sensitivity report.

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Section: Discussionmentioning

confidence: 99%

Correlation between biofilm formation and resistance toward different commonly used antibiotics along with extended spectrum beta lactamase production in uropathogenic Escherichia coli isolated from the patients suspected of urinary tract infections visiting Shree Birendra Hospital, Chhauni, Kathmandu, Nepal

Neupane

Pant

Khatiwada

et al. 2016

Antimicrob Resist Infect Control

Self Cite

114

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“…The bacterial isolates showing resistance toward three or more different classes of antibiotics were reported as multidrug resistant (MDR) [9].…”

Section: Performance Of Antimicrobial Susceptibility Testingmentioning

confidence: 99%

“…But recently, drug resistance among the bacteria is present as more serious public health problem. The irrational uses of the antibiotics have driven the evolution of antibiotic resistance, leading to increased morbidity and mortality along with increased health care cost and longer period of hospitalization [8,9]. In terms of the β-lactam antibiotics, bacteria are mainly resistant by producing enzymes, such as extended spectrum beta lactamase (ESBL), AmpC-beta-lactamase and carbapenem hydrolyzing enzymes (carbapenemases) [10].…”

Section: Introductionmentioning

confidence: 99%

Prevalence of carbapenem resistant bacterial strains isolated from different clinical samples: study from a tertiary care hospital in Kathmandu, Nepal

et al. 2017

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Background Carbapenems are considered as drugs of choice for the treatment of the infections caused by drug resistant bacteria. However, in the recent years the prevalence of carbapenem resistant gram negative bacteria has increased significantly. The main objective of this study was to determine the prevalence of carbapenemase producing gram negative bacteria among all the clinical isolates.Material and methods A total of 3246 non-repeated, different clinical specimens from patients attending Kathmandu Model Hospital, from July 2013 to January 2014 were cultured and the gram negative bacterial isolates obtained were subjected to identification with the help of colony morphology, Gram’s stain and conventional biochemical tests. Kirby-Bauer disk diffusion technique was used to perform antimicrobial susceptibility testing. Phenotypic confirmation of carbapenemase and AmpC beta-lactamase production was done by combined disc method.Results 890 samples showed the growth of bacterial pathogens. Out of total 769 gram negative bacteria, 57 were found to be carbapenem resistant. Of which, highest number (47) of the isolates were found to be metallo-β lactamase (MBL) producers. Six bacterial isolates produced both (Klebsiella pneumoniae carbapenemase) KPC and MBL, whereas only one isolate was found to be positive for both MBL and AmpC. Three bacterial strains showed carbapenem resistance due to over production of AmpC β-lactamase.Conclusion Among carbapenem resistant gram negative bacteria, MBL was present as the major enzyme responsible for resisting carbapenem antibiotics.

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“…In the treatment of these UTI patients, gentamicin and ceftriaxone was found effective in more than half of the cases nitrofurantoin in 46% cases, Cotrimoxazole (33%), ofloxacin (30%), nalidixic acid (16%), and ampicillin in only 5% cases. 16 In a meta-analysis, Tenney J, et al reported that 16/20 studies pointed out that the major risk factor leading to MDR microbes in urinary tract is antibiotic abuse and age; other factors includes urinary catheterization, and history of hospital stay and UTI. 17 McAllister R, et al studied UTI cases reported in the residents of nursing homes.…”

Section: 4mentioning

confidence: 99%

Multidrug-resistant urinary tract isolates of escherichia coli: Frequency and patient demographics in a Tertiary Care Hospital.

Azhar

Baig

Rasool

et al. 2020

TPMJ

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Urinary tract infections (UTIs) are a major burden to the health care as it is estimated that around 150 million UTIs occur yearly worldwide. Enterobacteriaceae are the most common agent causing serious urinary tract infections; and MDR cases are increasing day by day. Objectives: To determine the frequency and patient demographics of multidrug resistant urinary tract isolates of Escherichia Coli in a Tertiary Care Hospital. Study Design: Retrospective cross sectional study. Setting: Medicine Department of Madinah Teaching Hospital / The University of Faisalabad, Faisalabad. Period: From May 2016 to Sep 2018. Material & Methods: 187 patients of age 15 to 90 years with positive E. coli on urine culture and sensitivity were included in this Retrospective cross sectional study. All those patients with history of dysuria (pain during urination) or frequent urination (more than 7 times per day) were advised urine complete analysis and those with >5 WBCs or pus cells /HPF or having positive for leukocyte esterase and/or nitrite, were advised urine culture and sensitivity. Main outcome variable was the frequency of MDRE cases among the culture positive E. coli UTI patients. Results: Among all the cases of E. coli UTI, frequency of MDRE UTI was 66.8% (n=125) and rest 33.2% (n= 62) cases were not MDR UTI. 97.3% patients were resistant to lactam antibiotics, 95.7% were resistant to quinolones and 68.4% were resistant to aminoglycosides.

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Prevalence of multidrug resistant bacteria in causing community acquired urinary tract infection among the patients attending outpatient department of Seti Zonal Hospital, Dhangadi, Nepal

Cited by 25 publications

References 9 publications

Prevalence of carbapenem resistant bacterial strains isolated from different clinical samples: study from a tertiary care hospital in Kathmandu, Nepal

Multidrug-resistant urinary tract isolates of escherichia coli: Frequency and patient demographics in a Tertiary Care Hospital.

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