Study of Multidrug Resistance Pattern among Escherichia coli isolated from patients with Urinary tract infection
DOI:
https://doi.org/10.22159/ajpcr.2016.v9i6.13961Abstract
Objective: Urinary tract infections (UTIs) are some of the most common bacterial infections encountered in community and cause of significant morbidity and high medical cost. Escherichia coli is the most common pathogen belongs to Enterobacteriaceae family responsible for majority of UTI infections. Antimicrobial drugs have been routinely prescribed for empirical treatment of UTIs which has led to a dramatic increase in antibiotic resistance pattern of E. coli. The aim of present study was to analyse the multidrug resistance patterns (MDR) of E. coli isolated from UTI patients.
Methods: A total of 80 urine samples collected from the patients suspected of having UTI attending Maharishi Markandeshwar Institute of Medical Sciences and Research (MMIMSR), Mullana, Ambala were cultured using standard microbiological techniques. Antibiotic susceptibility testing of E.coli was done by using minimum inhibitory concentration (MIC). MIC of tetracycline, doxycycline, azithromycin, erythromycin, ciprofloxacin, levofloxacin, ampicillin, amoxicillin and amikacin was done by agar dilution method.
Results: Of the total 46 isolates contributing 33 females and 13 males were confirmed as E. coli. About 51.34% of the female patients belonged to the age group 21-40 yr and 53.84% of the male population belonged to 41-80 yr were found to be more susceptible to UTI infection. All isolates confirmed as E.coli were found to be multidrug resistant. 80% of the isolates exhibited MICs higher than 1000mg/L against β-lactams. 20% of the E. coli isolates exhibited MICs higher than 1000mg/L against ciprofloxacin, amikacin and erythromycin. 23% and 95% of E. coli isolates exhibited MICs less than 128 mg/L against doxycycline and levofloxacin respectively.
Conclusion: The present study revealed the decreased susceptibility of the E.coli to all drugs. E. coli resistance profile to beta lactams, quinolones, macrolides, tetracyclines and aminoglycosides were also found to be quite high in this study emphasizing the need to educate public about appropriate use of antibiotics.NA
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Stamm WE, Hooton TM. The management of urinary tract infection. N. Engl. J. Med. 1993; 329: 1328-1334.
Warren JW, Abrutyn E, Hebel JR, Johnson JR, Schaeffer AJ, Stamm WE. Guidelines fro antimicrobial treatment of uncomplicated acute bacterial cystis and acute pyelonephritis in women. Clin. Infect. Dis. 1999; 29:745-758.
Kolawale AS, Kolawale OM, Kandaki-Olukemi YT, Babatunde SK, Kolawale CF. Prevalence of urinary tract infections among patients attending Dalhatu Araf specialist hospital, Lafia, Nasarawa state, Nigeria. Int. J. Med. Sci. 2009; 1(5): 163-167.
Stamm WE, Norrby SR. Urinary tract infections: disease panorama and challenges. J. Infect. Dis. 2001; 183 (Suppl 1): S1-S4.
Hotchandani R, Aggarwal KK. Urinary tract infections in women. Indian J. Clin. Pract. 2012; 187-192.
Patel S, Taviad PP, Sinha M, Javadekar TB, Chaudhari VP. Urinary tract infections (UTI) among patients at GG Hospital and Medical College, Jamnagar. Natl. J. Community Med. 2012; 3: 138-141.
Chaudhuri SR, Thakur AR, Nandy P, Samanta S. Urinary tract infection- A survey of local population. Am. J. Infect. Dis. 2008; 4: 117-123.
Paape MJ, Schultze WD, Desjardins C, Miller R. Plasma corticosteroid circulating leukocyte and milk somatic cell responses to Escherichia coli endotoxin- induced mastitis. Proc. Soc. Exp. Biol. Med. 1974; 145: 553-559.
Todar K. Pathogenic E. coli online textbook of Bacteriology. University of Wisconsin-Madison. Department of Biotechnology; 2007.
Taur Y, Smith MA. Adherence to the Infectious Diseases Society of America guidelines in the treatment of uncomplicated urinary tract infection. Clin. Infect. Dis. 2007; 44: 769-774.
Zervos MJ, Hershberger E, Nicolau DP, Ritchie DJ, Blackner LK, Coyle EA, et al. Relationship between fluoroquinolone use and changes in susceptibility to fluoroquinolones of selected pathogens in 10 United States teaching hospitals., 1991-2000. Clin. Infect. Dis. 2003; 37: 1643-1648.
World Health Organization. Antimicrobial Resistance. Available at: http://www.who.int/mediacentre/factsheets/fs194/en/ (updated April 2014; cited April 2015).
Goldstein FW. Antibiotic susceptibility of bacterial strains isolated from patients with community- acquired urinary tract infections in France. Multicentre Study Group. Eur. J. Clin. Microbial Infect. Dis. 2000; 19: 112-117.
Mooljuntee S, Chansiripomchai P, Chansiripornchai N. Prevalence of the cellular and molecular antimicrobial resistance against E.coli isolated from Thai broilers. Thai. J. Veterinary Med. 2010; 40: 311-315.
Nickle JC. Urinary tract infections and resistant bacteria, in Highlights of a symposium at the combined meeting of the 25th International Congress of Chemotherapy (ICC) and the 17th European Congress of Clinical Microbiology and Infectious Diseases (ECCMID), held on March 31- April 3, 2007. Munich, germany, Rev. Urol. 2007; 9: 78-80.
Ashkenazi S, Even Tov S, Samra Z, Dinari G. Uropathogens of various childhood populations and their antibiotic susceptibility. Pediatr. Infect. Dis. J. 1991; 10: 742-746.
Mckellar QA, Sanchez Bruni SF, Jones DG. Pharmacokinetic/pharmacodynamic relationships of antimicrobial drugs used in veterinary medicine. J. Vet. Pharmacol. Ther. 2004; 27: 503-514.
Levy SB, Marshall B. Antibacterial resistance worldwide: causes, challenges and responses. Nat. Med. 2004; 10 (Suppl 12): S122-129.
Maxwell A. DNA gyrase as a drug target. Trends Microbiol.1997; 5:102-109.
Magiorakos AP, Srinivasan A, Carey RB, Carmeli Y, Falagas ME, Giske CG, et al. Multidrug resistant, extensively drug resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin. Microbiol. Infect. 2012; 18(3): 268-281.
Santo E, Salvador MM, Marin JM. Multidrug resistant urinary tract isolates of Escherichia coli from Riberirao Preto, Sao Paulo, Brazil. Braz. J. Infect. Dis. 2007; 11: 575-578.
Sarkar SK, Bhattacharya A, Mandal SM. YnfA, a SMR family efflux pump is abundant in Escherichia coli isolates from urinary infection. Indian J. Med. Microbiol. 2015; 33:139-142.
Somashekara SC, Deepalaxmi S, Jagannath N, Ramesh B, Laveesh MR, Govinddas D. Retrospective analysis of antibiotic resistance pattern to urinary pathogens in a Tertiary care hospital in South India. J. Basic Clin. Pharm. 2014; 5:105-108.
US Food and Drug Administration. National antimicrobial resistance monitoring system- enteric bacteria (NARMS): 2008 executive report. Rockville (MD). 2010; [cited 2012 Feb 13].http:// www.fda.gov/AnimalVeterinary/SafetyHealth/Antimicrobial Resistance/NationalAntimicrobialResistanceMonitoringSystem/default.htm.
Blaettler L, Mertz D, Frei R, Elzi L, Widmer AF, Battegay M, et al. Secular trend and risk factors for antimicrobial resistance in Escherichia coli isolates in Switzerland 1997-2007. Infection. 2009; 37: 534-539.
Hasan AS, Nair D, Kaur J, Baweja G, Deb M, Aggarwal P. Resistance patterns of urinary isolates in a tertiary Indian hospital. J. Ayub. Med. Coll. Abbottabad. 2007; 19: 39-41.
Scheld WM. Maintaining fluoroquinolone class efficacy: Review of influencing factors. Emerg. Infect. Dis. 2003; 9: 1-9.
Varughese L, Beniwal V. High quinolone resistant pattern among enteric pathogens isolated from patients with urinary tract infection. Indian J. Biotech. 2015; 14: 167-171.
Williams A, Mathai AS, Philips AS. Antibiotic prescription patterns at admission into a tertiary level intensive care unit in Northern India. J. Pharm. Bioallied Sci. 2011; 3: 531-536.
Andrews JM. Determination of minimum inhibitory concentration. J. Antimicrob. Chemother. 2001; 48: 5-16.
Wayne PA. CLSI, Performance Standards for Antimicrobial Susceptibility Testing: Twenty third Informational Supplement CLSI document, M100-S23 (Clinical and Laboratory Standards Institute); 2013.
Slama TG. Gram-negative antibiotic resistance: there is a price to pay. Crit. Care. 2008; 12(4): 1-7
Dash SK, Chakraborty SP, Mandal D, Roy S. Isolation and Characterization of Multidrug resistant uropathogenic Escherichia coli from urine sample of urinary tract infected patients. Int. J. Life Sci. Pharma Res. 2012; 2: 25-39.
Niranjan V, Malini A. Antimicroobial resistant pattern in Escherichia coli causing urinary tract infection among inpatients. Indian J. Med. Res.2014; 139: 945-948.
Gordona KA, Jones RN. Susceptibility patterns of orally administered antimicrobials among urinary tract infection pathogens from hospitalized patients in North America: Comparison report to Europe and Latin America. Results from the SENTRY Antimicrobial Surveillance Program (2000). Diagn. Microbiol. Infect. Dis.2003; 45: 295-301.
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