Retrospective analysis of antibiotic resistance pattern to urinary pathogens in a Tertiary Care Hospital in South India

Somashekara, Saligrama Chikkannasetty; Salmani, Deepalaxmi; Jagannath, Narumalla; Ramesh, Bannaravuri; Laveesh, Madathil Ravindran; Govindadas, Damodaram

doi:10.4103/0976-0105.141948

Cited by 34 publications

(45 citation statements)

References 6 publications

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“…This is consistent with other studies. (20)(21)(22)(23)(24) UTI is more common in females than in males, as female urethra structurally found less effective for preventing the bacterial entry. (25) It may be due to the proximity of the genital tract and urethra and adherence of urothelial mucosa to the mucopolysaccharide lining.…”

Section: Discussionmentioning

confidence: 99%

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Antibiotic Susceptibility Pattern of Klebsiella Pneumoniae Isolated From Cases of Urinary Tract Infection in a Tertiary Care Setup

Varghese¹,

George²,

Gopalakrishnan³

et al. 2016

jemds

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Urinary Tract Infection (UTI) is second on the ranking of most common infection in community practice. It leads to significant morbidity and a high economic burden for treatment. Klebsiella pneumoniae accounts for 2 nd highest organism isolated from urine samples of UTI patients after Escherichia coli. The management of UTI is complicated by the increasing prevalence of antibiotic resistant strains of Klebsiella pneumonia. Therefore, knowledge of the antibiotic resistance patterns of the pathogen is important not only to provide an appropriate therapy, but also for the prevention of resistance amongst the microbe. OBJECTIVEThe present study was therefore undertaken to determine the antibiotic susceptibility pattern of Klebsiella pneumonia causing UTI in patients admitted to a tertiary care hospital. MATERIAL AND METHODSThe details of Klebsiella pneumonia grown in urine samples received in the Department of Microbiology, MOSC Medical College, were collected from the laboratory registers. These urine samples were then processed using standard methods and antibiotic susceptibility testing was done by Kirby Bauer's disc diffusion method. RESULTDuring the period of 4 months, 35 urine samples yielding Klebsiella pneumonia were processed. These strains showed 100% resistance to Ampicillin, around 70-85% resistance to first, second and third generation Cephalosporins. They showed maximum sensitivity to Imipenem (74.3%), followed by Colistin (77%), Amikacin (65.7%), Meropenem (65.7%) and Piperacillin-Tazobactam (65.7%). CONCLUSIONIn our study, the high rate of resistance to routinely prescribed drugs like Co-trimoxazole, Norfloxacin and Nitrofurantoin could be attributed to the frequent use of these antibiotics. Carbapenems (Imipenem or Meropenem) and Amikacin should be considered as reserved drugs, especially for nosocomial infections.

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Section: Discussionmentioning

confidence: 99%

“…(31) to 98%. (20) In this study the resistance results were Amoxiclav (62.9%), Amikacin (32.3%), Nalidixic acid (51.4%) and Norfloxacin (48.6%). In a similar study, Somashekara SC et al showed the antibiotic resistance pattern of Klebsiella pneumonia to be Amoxiclav (68%), Amikacin (26%), Nalidixic acid (48.2%) and Norfloxacin (38%).…”

Section: Discussionmentioning

confidence: 99%

Antibiotic Susceptibility Pattern of Klebsiella Pneumoniae Isolated From Cases of Urinary Tract Infection in a Tertiary Care Setup

Varghese¹,

George²,

Gopalakrishnan³

et al. 2016

jemds

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“…[9][10][11][12][13][14] In Somasekara et al 13 study, highest resistance of E. coli was seen towards ciprofloxacin and ceftazidime (72% and 58% respectively). Cotrimoxazole resistance was also 68.8% whereas only 8% were imipenem resistant.…”

Section: Comparison Of Percentage Of Uropathogens Isolated In the Prementioning

confidence: 99%

Aetiology and Antibiotic Resistance Pattern of Uropathogens in a Tertiary Care Hospital

Kumari¹,

Ramya²,

Reddy³

et al. 2016

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Urinary tract infections (UTI) continue to be the commonest nosocomial infections. UTI is often treated with different broadspectrum antibiotics when one with a narrow spectrum of activity may be appropriate. The extensive use of antimicrobial agents have invariably resulted in development of antibiotic resistance, which in recent years has become a major problem worldwide. AIM AND OBJECTIVES1) Aim of the study is to isolate bacteria that cause urinary tract infections (UTI). 2) To understand resistance pattern of uropathogens which assist in choosing empirical therapy for urinary tract infections (UTI). MATERIALS AND METHODSThe present study was conducted on patients with clinically suspected UTI attending our hospital. 500 urine samples were collected from these patients and were tested. All the isolates were identified according to the standard biochemical tests and antibiotic susceptibility testing was done by disc diffusion method. RESULTS160 isolates of uropathogens isolated from 500 clinical samples of urine were included in this study. Among 160 isolates (major bacterial isolates from UTI), the predominant isolate was Escherichia coli and the second most common organism was Klebsiella spp. followed by CONS, Candida spp., Pseudomonas spp., Enterococcus spp., Acinetobacter spp., Staphylococcus aureus and Enterobacter. 25.62% of organisms were isolated from male patients and 74.37% were isolated from female patients. This showed a female predominance. Age group between 21-30 showed highest incidence of UTI followed by 1-10, 11-20, 31-40, 41-50, 61-75, 51-60 and ≥75. This showed more incidence of UTI among sexually active population. Escherichia coli predominated in hospital as well as in community patients. The second most common was Klebsiella spp. which predominated in hospitalised patients. Among the community patients, Escherichia coli predominated followed by Klebsiella spp., Enterococcus spp., CONS and Pseudomonas spp. In the present study, it was observed that ESBL production was 91.04% in Escherichia coli, 77.77% in Klebsiella spp., in Pseudomonas spp. it was 50%. MBL production was observed in 2.98% of Escherichia coli, 50% of Pseudomonas spp., 16.66% of Klebsiella spp. In this study, Gram-negative bacilli isolated from UTI were highly sensitive to amikacin and imipenem, and Grampositive organisms were sensitive to vancomycin and imipenem except Enterococci which showed 100% resistance to vancomycin.

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“…A very recent study from India showed high level (80%) of expression of efflux pumps specific to antimicrobial agents indicates antimicrobial resistance [22]. E. coli cultures isolated from urinary samples showed a high level of resistance to β-lactam and fluoroquinolones in recent study from South India [23]. The surveillance data show the highest resistance pattern of antimicrobial agents in E. coli that have been used from the long time in human medicine [24].…”

Section: Introductionmentioning

confidence: 99%

Study of Multidrug Resistance Pattern among Escherichia coli isolated from patients with Urinary tract infection

Goyal

Beniwal

2016

Asian J Pharm Clin Res

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Objective: Urinary tract infections (UTIs) are some of the most common bacterial infections encountered in community and cause of significant morbidity and high medical cost. Escherichia coli is the most common pathogen responsible for the majority of UTI infections. Antimicrobial drugs have been routinely prescribed for the empirical treatment of UTIs which has led to a dramatic increase in antibiotic resistance pattern of E. coli. The aim of the present study was to analyze the multidrug resistance (MDR) patterns of E. coli isolated from UTI patients.Methods: A total of 80 urine samples collected from the patients suspected of having UTI attending Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala, were cultured using standard microbiological techniques. Antibiotic susceptibility testing of E. coli was done using minimum inhibitory concentration (MIC). MIC of tetracycline, doxycycline, azithromycin, erythromycin, ciprofloxacin, levofloxacin, ampicillin, amoxicillin, and amikacin was done by agar dilution method. Results:Of the total 46 isolates contributing 33 females and 13 males were confirmed as E. coli. About 51.34% of the female patients belonged to the age group 21-40 years and 53.84% of the male population belonged to 41-80 years were found to be more susceptible to UTI infection. All isolates confirmed as E. coli were found to be MDR. 80% of the isolates exhibited MICs higher than 1000 mg/L against β-lactams. 20% of the E. coli isolates exhibited MICs higher than 1000 mg/L against ciprofloxacin, amikacin, and erythromycin. 23% and 95% of E. coli isolates exhibited MICs <128 mg/L against doxycycline and levofloxacin, respectively. Conclusion:The present study revealed the decreased susceptibility of the E. coli to all drugs. E. coli resistance profile to β-lactams, quinolones, macrolides, tetracyclines, and aminoglycosides were also found to be quite high in this study emphasizing the need to educate public about appropriate use of antibiotics.

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Retrospective analysis of antibiotic resistance pattern to urinary pathogens in a Tertiary Care Hospital in South India

Cited by 34 publications

References 6 publications

Antibiotic Susceptibility Pattern of Klebsiella Pneumoniae Isolated From Cases of Urinary Tract Infection in a Tertiary Care Setup

Antibiotic Susceptibility Pattern of Klebsiella Pneumoniae Isolated From Cases of Urinary Tract Infection in a Tertiary Care Setup

Aetiology and Antibiotic Resistance Pattern of Uropathogens in a Tertiary Care Hospital

Study of Multidrug Resistance Pattern among Escherichia coli isolated from patients with Urinary tract infection

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