A Study of ESBL Uropathogens in A Tertiary Care Hospital with Reference to their Antibiogram
Journal Title: Journal of Medical Science And clinical Research - Year 2015, Vol 3, Issue 7
Abstract
Background: To Process the urine specimens received to the laboratory. The aim of the study is to determine the type of uropathogens in the region and also to study their antibiotic sensitivity in a tertiary care hospital. Methods : A total of 7023 urine specimens of all age groups were processed in the central clinical microbiology laboratory of Narayana medical college for a period of 14 months from Sep 2012 to Oct 2013.Samples included of various type like Clean catch mid stream [CCMS], Cather collected, Suprapubic aspiration and nephrostomy. The specimens were inoculated on Nutrient agar, Blood agar and Macconkey agar and processed. Isolates identified by standard Biochemical tests and Antibiotic sensitivity was done by Kirby-Bauer disc diffusion method. ESBL isolates were identified by phenotypic disc diffusion method and antibiotic sensitivity was performed and results interpreted as per CLSI guidelines. Results: 5538 were culture positive and females were predominant over males with 3071 number as with other studies. Maximum age group in the study was between 51-60 years. Urinary tract infection was the major clinical condition followed by renal calculus, Diabetes. Escherichia coli was the predominant uropathogen in the study , Klebsiella pneumoniae, Acinetobacter sp, Pseudomonas aeruginosa, Citrobacter sp, Proteus Sp formed the rest .Enterococci sp was predominat gram positive uropathogens and rest include CONS, Staphylococcus aureus. Candida was also isolated. Gram negative uropathogens exhibited maximum sensitivity to Imipenam, Piperacillin + tazobactam and Amoxycillin+ clavulanic acid and maximum resistance to Amoxycillin,Cephalexin. E.coli exhibited moderate degree of sensitivity to Nitrofurantoin. In our study Klebsiella pneumoniae was the major ESBL uropathogen followed by Pseudomonas aeruginosa, Escherichia coli. Piperacillin+Tazobactam followed by Imipenem exhibited maximium sensitivity to ESBL uropathogens. Gram positive uropathogens demonstrated maximum sensitivity to Vancomycin and Linezolid. Conclusion: Monitoring and regular screening for the production of ESBL’s in the laboratory itself among uropathogens helps in prompt interventional measures in controlling ,spreading the development and dissemination of resistance in the community. The carbapnems should always be kept as reserve drugs in treatment of complicated UTI,s and in UTI,s caused by multi drug resistant uropathogens
Authors and Affiliations
Nagaram Punith Patak
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