Abstract
Background and Objective: Urinary tract infection (UTI) is the most common bacterial infection in human population leading to significant morbidity and health care costs. Expanded spectrum beta lactamase producing enterobacteriaceae hydrolyse expanded spectrum cephalosporins like ceftazidime, cefotaxmie. They play a significant role in UTI primarily in hospital admitted patients causing morbidity and mortality all over the world. Appropriate diagnosis and treatment are always challenging. An attempt was made to study retrospectively in the Department of Microbiology, Index Medical College about the prevalence of ESBL producing uropathogens belonging to enterobacteriaceae, isolated from patients with suggestive symptoms of urinary tract infection.
Method: Urinary isolates from symptomatic UTI cases were identified by conventional methods. A total of 1244 enterobacteriaceae isolated during October 2015 to October 2017. Antimicrobial susceptibility testing was done by Kauber-Bauer Disc Diffusion method following CLSI guidelines. Isolates resistant to cefotaxime (<_19mm) were tested for ESBL production by double disc synergy method.
Result: The most common isolated species was E.coli 943(76%) followed by Klebsiella spp. 227(18%) and other enterobacteriaceae 74(6%). Of all enterobacteriaceae, 673 (57%) among 1244 were ESBL producer. ESBL production was detected in 564(84%) E.coli, 92(14%) Klebsiella spp. and other enterobacteriaceae17(2%). More than 90% of the isolates were sensitive to amikacin, cefoperazone-sulbactam, imipenem and 36% isolates were sensitive to norfloxacin.
Conclusion: In the present study a large number of uropathogens were found to be ESBL producer. Monitoring ESBL production and antimicrobial susceptibility testing are necessary to avoid treatment failure in patients with urinary tract infection.
Keywords: Antibiotic susceptibility, ESBL, Urinary tract infection, Uropathogens.
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Corresponding Author
Dr Nilesh Chavan
Associate Professor, Department of Microbiology,
Index Medical College, Hospital and Research Centre, Indore, Madhya Pradesh
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