Burden of Multidrug Resistant Escherichia coli among Patients with Urinary Tract Infections in a Tertiary Care Centre- A Retrospective Analysis
Introduction: Multidrug Resistant (MDR) Escherichia coli isolates causing Urinary Tract Infections (UTIs), capable of producing Extended Spectrum Beta Lactamase (ESBL), AmpC beta lactamase and resistance to carbapenems pose serious challenges to the clinicians causing worse clinical scenarios. T...
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JCDR Research and Publications Private Limited
2021-09-01
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| Series: | Journal of Clinical and Diagnostic Research |
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| Online Access: | https://www.jcdr.net/articles/PDF/15343/50159_CE[Ra1]_F(SHU)_PF1(AG_OM)_PFA-2(KM_AG)_PB2(AG_KM)_PN(KM).pdf |
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| author | Manjula Sidlagatta Ramakrishna Gomathi Chitra Abimannan Lavanya Jeyamani Aparna Ramalingam Karthik Anbalagan |
| author_facet | Manjula Sidlagatta Ramakrishna Gomathi Chitra Abimannan Lavanya Jeyamani Aparna Ramalingam Karthik Anbalagan |
| author_sort | Manjula Sidlagatta Ramakrishna |
| collection | DOAJ |
| description | Introduction: Multidrug Resistant (MDR) Escherichia coli isolates
causing Urinary Tract Infections (UTIs), capable of producing
Extended Spectrum Beta Lactamase (ESBL), AmpC beta lactamase
and resistance to carbapenems pose serious challenges to the
clinicians causing worse clinical scenarios. The detection of these
isolates has prime importance in infection control and improving
therapeutic management of patients, as their prevalence is increasing
worldwide. Injudicious use of antibiotics has led to selective
pressure, resulting in the emergence of antibiotic resistance in
gram negative bacteria globally. This rise in antimicrobial resistance
has decreased the options for empirical therapy, causing a global
health concern in infections associated with ESBL producing and
AmpC producing isolates.
Aim: To investigate the burden of ESBL producing, AmpC
beta-lactamase producing, carbapenem resistant, and MDR
Escherichia coli isolated from urine samples in a tertiary care
centre.
Materials and Methods: The present retrospective study conducted
from January to December 2019. A total of 10,535 urine samples
were received during the study period, to find out the burden of
drug resistant Escherichia coli isolates in urine samples, analyse
their antibiogram and patients’ socio-demographic information.
Records of microscopic observations to antibiogram of each isolate
was noted down from the register for urine samples, and further
analysed. The data was coded, verified, entered and analysed
using Statistical Package for Social Sciences (SPSS) version 18.0.
Results: Among the total urine samples (10,535), 1434 (13.6%)
Escherichia coli isolates were identified, of which 553 (38.6%)
were found to be ESBL producing, 497 (34.6%) AmpC betalactamase producing, 172 (12%) Carbapenem resistant, and
765 (53.3%) MDR. Majority of the isolates were from the age
group of 51-60 years 288 (20.08%). The least susceptibility of
the isolates was detected against penicillin G 1410 (98.3%),
followed by ampicillin 1160 (80.9%) and cephazolin 74 (67.9%).
Among the MDR isolates, the maximum drug resistance (398,
52%) was seen in penicillin, cephems, quinolones and Folate
pathway antagonist group of antimicrobials.
Conclusion: Identification of the drug resistant isolates is of high
priority and crucial for therapeutic management of the patients,
and infection control. Stringent antimicrobial stewardship policies
and judicious use of antimicrobials can decrease the spread of
antimicrobial resistant genes in the hospital environment. |
| first_indexed | 2024-12-20T00:19:14Z |
| format | Article |
| id | doaj.art-78e198c18bdd43aebe7abdbc6122b3d2 |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-12-20T00:19:14Z |
| publishDate | 2021-09-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-78e198c18bdd43aebe7abdbc6122b3d22022-12-21T20:00:14ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2021-09-01159DC01DC0610.7860/JCDR/2021/50159.15343Burden of Multidrug Resistant Escherichia coli among Patients with Urinary Tract Infections in a Tertiary Care Centre- A Retrospective AnalysisManjula Sidlagatta Ramakrishna0Gomathi Chitra Abimannan1Lavanya Jeyamani2 Aparna Ramalingam3Karthik Anbalagan4Assistant Professor, Department of Microbiology, SRM Medical College Hospital and Research Centre, Potheri, Tamil Nadu, India.Assistant Professor, Department of Microbiology, SRM Medical College Hospital and Research Centre, Potheri, Tamil Nadu, India.Associate Professor, Department of Microbiology, KMCH Institute of Health Science and Research, Coimbatore, Tamil Nadu, India.Student, Department of Microbiology, SRM Medical College Hospital and Research Centre, Potheri, Tamil Nadu, India.Tutor, Department of Microbiology, SRM Medical College Hospital and Research Centre, Potheri, Tamil Nadu, India.Introduction: Multidrug Resistant (MDR) Escherichia coli isolates causing Urinary Tract Infections (UTIs), capable of producing Extended Spectrum Beta Lactamase (ESBL), AmpC beta lactamase and resistance to carbapenems pose serious challenges to the clinicians causing worse clinical scenarios. The detection of these isolates has prime importance in infection control and improving therapeutic management of patients, as their prevalence is increasing worldwide. Injudicious use of antibiotics has led to selective pressure, resulting in the emergence of antibiotic resistance in gram negative bacteria globally. This rise in antimicrobial resistance has decreased the options for empirical therapy, causing a global health concern in infections associated with ESBL producing and AmpC producing isolates. Aim: To investigate the burden of ESBL producing, AmpC beta-lactamase producing, carbapenem resistant, and MDR Escherichia coli isolated from urine samples in a tertiary care centre. Materials and Methods: The present retrospective study conducted from January to December 2019. A total of 10,535 urine samples were received during the study period, to find out the burden of drug resistant Escherichia coli isolates in urine samples, analyse their antibiogram and patients’ socio-demographic information. Records of microscopic observations to antibiogram of each isolate was noted down from the register for urine samples, and further analysed. The data was coded, verified, entered and analysed using Statistical Package for Social Sciences (SPSS) version 18.0. Results: Among the total urine samples (10,535), 1434 (13.6%) Escherichia coli isolates were identified, of which 553 (38.6%) were found to be ESBL producing, 497 (34.6%) AmpC betalactamase producing, 172 (12%) Carbapenem resistant, and 765 (53.3%) MDR. Majority of the isolates were from the age group of 51-60 years 288 (20.08%). The least susceptibility of the isolates was detected against penicillin G 1410 (98.3%), followed by ampicillin 1160 (80.9%) and cephazolin 74 (67.9%). Among the MDR isolates, the maximum drug resistance (398, 52%) was seen in penicillin, cephems, quinolones and Folate pathway antagonist group of antimicrobials. Conclusion: Identification of the drug resistant isolates is of high priority and crucial for therapeutic management of the patients, and infection control. Stringent antimicrobial stewardship policies and judicious use of antimicrobials can decrease the spread of antimicrobial resistant genes in the hospital environment.https://www.jcdr.net/articles/PDF/15343/50159_CE[Ra1]_F(SHU)_PF1(AG_OM)_PFA-2(KM_AG)_PB2(AG_KM)_PN(KM).pdfampc β-lactamasescarbapenem resistanceco-morbiditiesco-infectionextended spectrum beta lactamase |
| spellingShingle | Manjula Sidlagatta Ramakrishna Gomathi Chitra Abimannan Lavanya Jeyamani Aparna Ramalingam Karthik Anbalagan Burden of Multidrug Resistant Escherichia coli among Patients with Urinary Tract Infections in a Tertiary Care Centre- A Retrospective Analysis Journal of Clinical and Diagnostic Research ampc β-lactamases carbapenem resistance co-morbidities co-infection extended spectrum beta lactamase |
| title | Burden of Multidrug Resistant Escherichia coli among Patients with Urinary Tract Infections in a Tertiary Care Centre- A Retrospective Analysis |
| title_full | Burden of Multidrug Resistant Escherichia coli among Patients with Urinary Tract Infections in a Tertiary Care Centre- A Retrospective Analysis |
| title_fullStr | Burden of Multidrug Resistant Escherichia coli among Patients with Urinary Tract Infections in a Tertiary Care Centre- A Retrospective Analysis |
| title_full_unstemmed | Burden of Multidrug Resistant Escherichia coli among Patients with Urinary Tract Infections in a Tertiary Care Centre- A Retrospective Analysis |
| title_short | Burden of Multidrug Resistant Escherichia coli among Patients with Urinary Tract Infections in a Tertiary Care Centre- A Retrospective Analysis |
| title_sort | burden of multidrug resistant escherichia coli among patients with urinary tract infections in a tertiary care centre a retrospective analysis |
| topic | ampc β-lactamases carbapenem resistance co-morbidities co-infection extended spectrum beta lactamase |
| url | https://www.jcdr.net/articles/PDF/15343/50159_CE[Ra1]_F(SHU)_PF1(AG_OM)_PFA-2(KM_AG)_PB2(AG_KM)_PN(KM).pdf |
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