PHENOTYPIC DETECTION OF EXTENDED-SPECTRUM BETA LACTAMASES (ESBLS) PRODUCING ORGANISMS AMONG ENTEROBACTERIACEAE AND THEIR ANTIBIOTIC RESISTANCE PATTERN IN URINARY TRACT INFECTION (UTI) AT KUMAUN REGION, UTTARAKHAND
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 16
Abstract
BACKGROUND Urinary tract infection (UTI) is one of the major health problems affecting all age groups. Extended Spectrum β-Lactamases (ESBLs) producing Enterobacteriaceae exhibits a resistant mechanism, which challenges the strategies of broad-spectrum antibiotics used in treatment of UTI, thus limiting therapeutic options. Knowing resistance pattern of such multidrug resistant pathogens will help in the appropriate usage of antimicrobial agents. The study was carried out to determine the prevalence of ESBL among the Enterobacteriaceae uropathogens and their antimicrobial resistance pattern. MATERIALS AND METHODS All the uropathogenic isolates obtained from symptomatic UTI cases were identified by conventional methods. The prevalence of potential ESBL producers among Enterobacteriaceae isolates was explored. Antimicrobial susceptibility testing was done by KirbyBauer disc diffusion method and the results were interpreted according to Clinical Laboratory Standards Institute 2014 guidelines. Study Design- Descriptive study. Place and Duration of Study- Department of Microbiology, Government Medical College and Hospital, Haldwani from November 2013 to September 2015. RESULTS A total of 695 clinical isolates were obtained from 2438 urine samples. Out of these 695 isolates 454 (65.32%) isolates were from Enterobacteriaceae family, out of which a total of 188 (41.4%) isolates were ESBLs producing Enterobacteriaceae which predominantly comprised of Klebsiella pneumoniae (65.71%) followed by Escherichia coli (40.56%) and Proteus species (34.28%). A high degree of resistance to ampicillin (98.4%) and cotrimoxazole (93.08%) were found among these ESBL producing Enterobacteriaceae isolates followed by gentamicin (58.51%) and ciprofloxacin (55.31%). Nitrofurantoin and Amikacin were found to be most effective drugs. CONCLUSION A large number of uropathogens were found to be ESBL producers in the present study. Most of the ESBL producing isolates were multidrug resistant. Monitoring of ESBL production, judicious use of antibiotics and infection control measures are necessary to avoid treatment failure in patients with UTI.
Authors and Affiliations
Hitendra Singh, Umesh Umesh
Keywords
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- EP ID EP414637
- DOI 10.14260/jemds/2018/453
- Views 73
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