Multidrug-Resistance and Extended Spectrum Beta-Lactamase Production in Uropathogenic E. Coli which were Isolated from Hospitalized Patients in Kolkata, India
ABSTRACT Background and Objective: Urinary Tract Infections (UTIs) are mostly caused by Escherichia coli. The appropriate therapy demands a current knowledge on the antimicrobial susceptibility pattern amongst these pathogens, as an inappropriate use of antibiotics may lead to complications and...
Main Authors: | , , , |
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Format: | Article |
Language: | English |
Published: |
JCDR Research and Publications Private Limited
2013-03-01
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Series: | Journal of Clinical and Diagnostic Research |
Subjects: | |
Online Access: | https://www.jcdr.net/articles/PDF/2796/10-%204990_u.pdf |
Summary: | ABSTRACT
Background and Objective: Urinary Tract Infections (UTIs)
are mostly caused by Escherichia coli. The appropriate therapy
demands a current knowledge on the antimicrobial susceptibility
pattern amongst these pathogens, as an inappropriate use of
antibiotics may lead to complications and treatment failure.
The UTIs which are caused by multidrug resistant ExtendedSpectrum Beta-Lactamase (ESBL) producing bacteria further
pose a severe problem, as the treatment options are limited.
The aim of this study was to identify the pattern of multi drug
resistance amongst the uropathogenic E. coli (UPEC) isolates
which were obtained from hospitalized patients.
Materials and Methods: Forty UPEC were isolated from 200
urine samples of hospitalized patients who were clinically
suspected for UTIs. Antimicrobial susceptibility screening was
performed by using 16 antibiotics, by the Kirby Bauer disk
diffusion technique. The isolates which were resistant to the
third generation cephalosporins were subjected to the ESBL
confirmatory test by using drug and drug-inhibitor combination
disks by following the CLSI guidelines.
Results: All the 40 isolates except three were multidrug
resistant. They showed the highest sensitivities for nitrofurantoin
(72.5%) and amikacin (70%). A high level of resistance
was observed against ampicillin (97.5%), nalidixic acid and
cefelexin (95%), amoxicillin (92.5%), cotrimoxazole (82.5%)
and ciprofloxacin (80%) respectively. Thirty different antibiotic
resistance patterns were observed against the different
antibiotics. Twenty-eight out of the 40 isolates were resistant to
the third generation cephalosporins. However, the phenotypic
test for the ESBL confirmation indicated that eighteen out of
the twenty-eight isolates were ESBL producers and that eleven
different drug resistance patterns were observed amongst
them.
Conclusions: Therefore, this study accounts for the varied
multidrug resistance pattern amongst the uropathogenic E. coli
which were isolated from hospitalized patients in Kolkata, an
eastern region of India. Nitrofurantoin and amikacin should be
assigned as potent drugs to treat this infection in this region
of the country. These varied resistance patterns present major
therapeutic and infection control challenges and they suggest a
heterogeneous population of the uropathogenic E. coli isolates
which circulate in this sector of India.
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ISSN: | 2249-782X 0973-709X |