Abstract
Urinary tract infections (UTIs are the second most common bacterial infections in general practice and a frequent indication for prescription of antimicrobials. Resistant Extended spectrum β lactamases (ESBL bacteria are increasingly reported worldwide. They are mainly found in Escherichia coli, Klebsiella species and Proteus species but can occur in other members of Enterobacteriaceae family. This was prospective study conducted in a tertiary care hospital in South India from Oct 2012 to May 2015. Urine samples of clinically suspected with UTI were collected. Samples received included mid-stream clean catch urine, suprapubic aspirate and from Foley's catheter. Samples were processed and isolates were identified as per standard methods. ESBL detection was done with combination disk and MIC reduction test. A total of 227 Klebsiella pneumoniae (K. pneumoniae were isolated, 85 (37.4% were ESBL producers. Highest resistance to K. pneumoniae was seen with Ampicillin and Piperacillin and least with Aztreonam and Imipenem. Out of 186 Proteus mirabilis (P. mirabilis, 59 (31.7% were ESBL producers. Highest resistance to P. mirabilis was seen with Ampicillin, Amoxycillin-clavulanic acid and Piperacillin, least with Aztreonam and Imipenem. The present study showed a high percentage of ESBL producers among clinical isolates of K. pneumoniae and P. mirabilis to commonly used antibiotics. After Impinem and Aztreonam, the most sensitive drugs for K. pneumoniae were Piperacciilin + Tazobactum and Nitrfurantoin. After Impinem and Aztreonam, the most sensitive drugs for P.mirabilis were Aminoglycosides and Nitrfurantoin. Knowledge of antibiogram studies will help physicians in choosing a empirical treatment. Regular antibiotic susceptibility studies should be conducted to know the changing trends in resistance.
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