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ORIGINAL ARTICLE
Year : 2015  |  Volume : 2  |  Issue : 1  |  Page : 19-24

Prevalence of multidrug resistance and extended spectrum beta-lactamases among uropathogenic Escherichia coli isolates in a tertiary care hospital in South India: An alarming trend


Department of Microbiology, Vydehi Institute of Medical Sciences and Research Centre, Whitefield, Bengaluru, Karnataka, India

Correspondence Address:
Chittur Yerat Ranjini
A G 11, DSR Sunshine Apartments, Krishna Reddy Layout, 1st main, 2nd Cross, Banaswadi, Bengaluru - 560 043, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2225-6482.153861

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Background and Aims: Escherichia coli is the most common etiological agent in both community acquired and hospital acquired urinary tract infections. Emergence of multidrug resistance (MDR) among E. coli isolates is quite alarming. The aim of this study was to define the current prevalence of MDR and extended spectrum beta-lactamases (ESBL) production among E. coli isolates from urine samples in our hospital. Materials and Methods: Urine samples from 1225 patients were processed for wet mount followed by culture and sensitivity. All the samples were inoculated on to Hi Media Hi chrome agar plates (HiMedia Laboratories Pvt. Ltd., Mumbai, India) and growth showing significant bacteriuria (≥10 5 cfu/ml) were further identified by the standard biochemical procedures and antibiotic sensitivity done as per Clinical and Laboratory Standards Institute guidelines. Detection of ESBL was done by the combined disc method. Percentage of antibiotic resistance and sensitivity and Chi-square test were used. Results: Out of 1225 samples processed, significant bacterial isolates were obtained in 357 (29.1%). The total number of E. coli isolated were 179 (50.1%) of which multidrug resistant E. coli isolates were 148 (82.6%) and 71 (39.66%) were ESBL producers. High degree of resistance was observed to amoxycillin (93.2%) and amoxycillin-clavulanic acid (90.5%). More than 80% sensitivity was seen only to imipenem (98.4%), amikacin (83.3%) and nitrofurantoin (86.6%). Conclusion: Multidrug resistant strains of E. coli are widely prevalent in the community. Antibiotics like imipenem require hospitalization, parenteral administration, drug monitoring for toxicity, all of which incur high cost to the patient and have to be used judiciously.


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