Title: E-Coli Sensitivity Pattern at Tertiary Hospital in Telangana and Its Clinical Significance
Authors: Dr Ajay Kumar Khandal, Dr D. Raghuraman, Dr D.C.Thirupathi Rao, Dr Ghiyasuddin Ahmed Masror
DOI: https://dx.doi.org/10.18535/jmscr/v5i5.231
Abstract
Background & Objectives: Urinary tract Infection (UTI) is a common cause of hospitalisation, with Escherichia coli (E.coli) being the commonest organism. local resistance pattern is of paramount help in treating the organism empirically, periodic study to this end is mandated to strengthen the cause of antibiotic stewardship. This study was undertaken for the aforesaid objective in the patients of tertiary care hospital of Telangana.
Methods: Positive Urine Culture reports were collected from microbiology department from April to October 2016 period, antibiotic susceptibility reports were conducted as in the Clinical and Laboratory Standards Institute (CLSI) guidelines. The resistance patterns were studied for clinical significance.
Results: A total of 41 inpatients samples were included in the study. The resistance pattern detected was as follows: floroquinolones (91%); third generation cephalosporins (85%); trimethoprim-sulphamethoxazole (TMP-SMX) (81%); aminoglycosides-gentamycin (58%); piperacillin/tazobactum (46%); amikacin (42%); nitrofurantoin (31%); carbapenem (12%). A significant number—greater than 81 percent—are harbouring multi-drug resistance as observed by resistance to 3 class of antibiotics. With well over 85 percent resistance to third generation cephalosporins, suggesting possible ESBLs.
Conclusions: The resistance pattern is distressing as the empirical choice of upper tract infection viz., ceftriaxone and piperacillin tazobactam, cannot be used when the resistance is as high as 85 percent and 46 percent respectively. A greater than 10 percent carbapenem resistance (CR) is more agonising as it implies a grave possibility of treatment failure in a seriously ill individual. Fortunately, this pattern might not be reflective of community acquired E.coli.
Keywords: UTI, ESBLs, E.COLI, MDR strains, HAI.
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