Aerobic bacterial profile and antimicrobial resistance in bacterial isolates causing urinary tract infection in patients attending at integral institute of medical sciences and research hospital Lucknow
Journal Title: International Journal of Medical and Health Research - Year 2018, Vol 4, Issue 4
Abstract
Background: Emergence of antibacterial resistance and production of extended spectrum β-lactamases (ESBLS) are responsible for the frequently observed empirical therapy failures. Most countries have experienced rapid dissemination of esbls producing Enterobacteriaceae isolates, particularly E. coli and Klebsiella pneumoniae. Esbls are clinically significant and when detected, indicate the need for the use of appropriate antibacterial agents. But antibacterial choice is often complicated by multi-resistance. Methods: This study was carried from January to June study the multidrug resistant (MDR) Enterobacteriaceae and ESBL producing E. coli among urine isolates in hospital setting. Isolates from urine samples were primarily screened for possible ESBL production, ampc production, mbl production followed by phenotypic confirmation. Antibiotic susceptibility testing (AST) was done by Kirby Bauer disk diffusion method following Clinical and Laboratory Standard Institute (CLSI) guidelines. Results: Total number of 354 sample were included in this study. Out of which 149 sample were positive by culture. The culture was positive for Enterobacteriaceae and non Enterobacteriaceae family. In this study total 149 (42.09%) sample were positive for culture. Out of 149 sample 95 samples were positive for Enterobacteriaceae and 54 samples were positive for non Enterobacteriaceae. Enterobacteriaceae included 75(50.33%) E. coli, 14 (9.39 %) Klebsiella, 5(3.35%) Proteus, 1 (0.67%) Citrobacter. Other non enterobacteriace isolates were 2(1.34%) Acinetobacter, 2(1.34%) Pseudomonas, 9(6.04%) Staphylococcus, 1(0.67%) Streptococcus, 29(19.46%) Enterococcus and 11(7.38%) Candida. Total 354(100%), Positive 149(42.09%), Resistance 58(38.93%0), Esbl 30 (51.72%), 19 E.coli, 10 Klebsiella, 1 Proteus, Ampc17 (29.31%), 10 E.coli, 6 Klebsiella, 1 Proteus, Mbl4 (6.89%), 3 E.coli, 1 Proteus, Mrsa5(8.62%), 5 Staphylococcus, Vre2(3.44%), 2 Enterococcus. Conclusions: Using the phenotypic confirmatory test forwarded by the CLSI, relatively significant E. coli isolates tested were ESBL producers. Also high numbers of MDR organisms were isolated among Enterobacteriaceae. Isolates showed significant resistance to the commonly prescribed drugs. These findings suggest for further study in this field including the consequences of colonization with MDR and ESBL-producing bacteria both in the community and in the hospital setting.
Authors and Affiliations
Dr. Shilpi Srivastava, Nidhi Singh, Dr. Sanjeev Sahai, Dr. Meenakhi Srivastava, Imran Azmi
Keywords
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