COMPARISON OF CHROMOGENIC AGAR MEDIUM VERSUS CONVENTIONAL MEDIA FOR IDENTIFICATION OF UROPATHOGENS AND EVALUATION OF EXTENDED SPECTRUM BETA LACTAMASES
Journal Title: Journal of Biomedical and Pharmaceutical Research - Year 2015, Vol 4, Issue 1
Abstract
Introduction: Use of chromogenic media allows more specific and direct differentiation of microorganisms reducing the need for further identification and time required for reporting the results. The frequency of ESBL production has increased among Gram negative uropathogens in the last few decades. Materials and Methods: 105 mid stream urine samples were inoculated on Blood, Mac conkey, Cystein lactose electrolyte deficient (CLED) and HiCrome UTI agar. The colonies obtained on HiCrome agar were identified based on color of the colonies (manufacturer’s instructions followed) while colonies obtained on other media were identified by standard biochemical reactions. Antibiotic sensitivity testing was done by Kirby-bauer disc diffusion method as per CLSI guidelines. ESBL production was confirmed by combined disc diffusion method using Cefotaxime, Cefotaxime plus clavulinic acid and Ceftazidime, Ceftazidime plus clavulinic acid discs. Results: Out of 105 urine samples, 48 showed single type of colony, 03 showed two types of colonies. Mixed growth was seen in 04 samples. Most common bacteria isolated was E.coli (18/54), followed by Staphylococci (11/54), Enterococci (10/54), Klebsiella (07/54) Pseudomonas (04/54), Proteus mirabilis (03/54) and Acinetobacter (01/54). All isolates grew on HiCrome UTI agar (100%). Two isolates did not grow on CLED medium. Bacterial isolates identified on HiCrome Agar were matching to 100% with that identified by biochemical reactions Majority of the isolates were resistant to cefpodoxime (81.1%) followed by ceftazidime (79.6%), norfloxacin (64.8%), cotrimoxazole (61.1%), cefotaxime (59.2%), nitrofurantoin (35.1%), imipenem (3.7%). ESBL production was detected in 18 out of 33 Gram negative uropathogens (54.54%). E.coli ranked first among the ESBL producers (72.22%). Conclusion: HiCrome UTI agar can be used as an easy to use primary screening medium that reduces the work load and identification tests. Knowledge about susceptibility pattern of uropathogens in particular area is important and ESBL detection methods are mandatory before empirical antibiotic therapy.
Authors and Affiliations
Dr. Usha M. G| M.D, Professor of Microbiology, JJM Medical College, Davanagere, Karnataka, India., Dr. Shwetha D. C| Assistant professor of Microbiology, Basaveshwara Medical College, Chitradurga, Karnataka, India.
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