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Category: Volume 07 Issue 06 June 2019
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Title: Nitrofurantoin as an option in the treatment of Extended Spectrum Beta-Lactamase Producing Escherichia Coli and Klebsiella Pneumoniae in Uncomplicated UTI

Authors: Dusi Ratna Harika, Tiruvaipati Sirisha, Pilli Hemaprakash Kumari, Nitin Mohan, Sasapu Swapna

 DOI: https://dx.doi.org/10.18535/jmscr/v7i6.142

Abstract

Extended Spectrum Beta- Lactamase (ESBL) producing organisms causing urinary tract infections (ESBL-UTI) are increasing in incidence and pose a major burden to health care. Although 95-100% ESBL organisms are considered sensitive to meropenem, rapid emergence of carbapenem resistance has been documented in many countries. The choice of treatment for carbapenamase producing organisms is very limited. The present study is aimed to evaluate the antibiotic susceptibility patterns in urinary tract infections caused by ESBL producing E.coli and Klebsiella species.

A total of 576 Urine samples from out-patients are taken and data regarding previous hospitalization and antibiotic administration is collected. E.coli and Klebsiella pneumoniae are major isolates in this prospective study. The study also involves the effect of demographic variables on ESBL producers and sensitivity to antibiotics. Maximum ESBL isolates were reported from K.pneumoniae (93%) and majority of the isolates were from female urine samples. ESBL producing  E.coli also showed maximum sensitivity to colistin (95%) followed by nitrofurantoin (88.4%) and ESBL producing K.pneumoniae showed maximum sensitivity to colistin (93.4%) followed by nitrofurantoin (58.9%).From the present study it was concluded that, Nitrofurantoin can be incorporated as a key antibiotic for Antimicrobial stewardship programme for empirical therapy.

Keywords: UTI, ESBL, Nitrofurantoin, Colistin.

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Corresponding Author

Dr T. Sirisha

Assistant Professor, Department of Microbiology, GIMSR, GITAM (Deemed to be University)