A clinco-microbiological profile of carbapenem resistance among nosocomial infections in a tertiary care hospital

Abstract

Background: Escherichia coli is the most common etiological gent in both community acquired and hospital acquired urinary ract infections (UTI). Emergence of multidrug resistance (MDR) mong E.coli isolates is quite alarming. The goal of the study was to efine the current prevalence and phenotypes ofMDR E. coli among TI samples in our hospital. Methods: Urine samples from 1225 patients received in the icrobiology department of our hospital were processed. Wet ount to detect presence of pus cells and bacteria was done. All he samples were inoculated on to Hi Media Hi chrome agar and lates incubated at 370 C for 18-24 hours. Growth showing sigificant bacteriuria (≥ 105 cfu/ml) was identified by the colour mparted by the colonies. Further identification was done by the tandard biochemical procedures. Antibiotic sensitivity was perormed by disc diffusion method as per CLSI guidelines. Various lasses of antibiotics were included in the sensitivity panel. Results: Out of 1225 samples processed, significant bacterial solates were obtained in 357 (29.1%) The total number of E.coli solatedwere 179(50.1%). More number of females (56.9%) had sigificantUTI due to E.coli compared tomales (43%). The total number f samples received in pediatric age groupwas 60. E.coli comprised 8.3% of the pediatric isolates. Total numbers of multidrug resisant E.coli isolates were 148 (82.6%). High degree of resistance was bserved 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 revalent and isolation of the same in the community acquired uriary tract infections is a matter of grave concern. Antibiotics like mipenem and amikacin require hospitalization, parentral adminstration, drug monitoring for toxicity, all of which incurs high cost o the patient and cannot be used as the first line of treatment. Judiious use of antibiotics is the need of the hour to prevent spread of he multidrug resistant strains in the community