Abstract
Urinary tract infections (UTIs) are one of the most common bacterial infections in humans, both in the community and the hospital settings. An extensive use of β -lactam antibiotics in hospitals and community has created major resistance problem leading to increased morbidity, mortality and health-care costs. Local knowledge of antimicrobial susceptibilities of these organisms is important for implementation of effective hospital anti-infective policies. The objective of the study was to determine the prevalence of ESBL producers along with their antimicrobial sensitivity pattern in the urinary isolates of Gram negative bacilli. The study was carried out in the Department of Microbiology, Army Medical College, looking after an 1100 bedded tertiary care hospital from December 2009 to November 2010. A total of 826 clinical isolates of Gram negative bacilli were recovered from the routine clinical samples of urine from the inpatient and outpatient departments of the hospital. Three hundred and sixty four (364) ESBL producers were identified from these isolates. Escherichia coli was the most frequent ESBL producer in this group followed by Klebsiella pneumoniae and Enterobacter spp. Carbapenems were found to be the most effective drug followed by Amikacin and Nitrofurantoin. The high prevalence of ESBL producers in the urinary isolates in our study warrants the need for judicious use of antibiotics to control the spread of antibiotic resistance in these bacteria. Key words: Urinary isolates, gram negative bacilli, ESBL, antibiotic resistance.
Highlights
The increasing incidence and complexity in the resistance mechanisms of the pathogenic bacteria and their widespread distribution globally has created a worrisome clinical dilemma with the treatment of common ailments becoming more and more of a challenge
The high prevalence of extendedspectrum beta lactamase (ESBL) producers in the urinary isolates in our study warrants the need for judicious use of antibiotics to control the spread of antibiotic resistance in these bacteria
The alarming number of new cases of multi-drug resistant (MDR) and extremely drug resistant (XDR) tuberculosis, widespread resistance to earlier generation of anti-malarial medicines in malaria endemic regions, a high percentage of hospital-acquired infection caused by methicillin-resistant Staphylococcus aurues (MRSA) and vancomycin- resistant Enterococcus species are all harbinger of the tough times ahead for the
Summary
The increasing incidence and complexity in the resistance mechanisms of the pathogenic bacteria and their widespread distribution globally has created a worrisome clinical dilemma with the treatment of common ailments becoming more and more of a challenge. The lifetime risk for UTI in females is greater than 50% (Griebling, 2005). This is mainly because of shorter urethra in women; this is why women are more likely to get an infection after sexual activity or when using a diaphragm for birth control. It is very important to understand the changing trends in the antibiotic resistance of the causative organisms as it has a direct bearing on the treatment of UTI. The knowledge of the presence of this resistance mechanism indicates the potential of spread to other patients as well as within the community
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