Urinary E.coli isolates in tertiary care centre of south Kerala: Antibiogram and ESBL detection by phenotypic confirmatory disc diffusion testing

Abstract

Gram negative bacterial infections are the most important cause of Urinary Tract Infections (UTI) in India. E.coli being the most common isolate and has been resistant to commonly used antibiotics. Materials and Methods: This study was done to assess the antibiotic sensitivity pattern of uropathogenic E.coli and to detect Extended-spectrum ? lactamase E coli isolated from samples collected in patients with urinary tract infections. Antibiotic sensitivity pattern was assessed using CLSI 2017 guidelines. ESBL detection was carried out using phenotypic Confirmatory Disc Diffusion Test Results: 87 E.coli isolates were collected from urinary samples during the study period. Antibiotic sensitivity profiles showed that uropathogenic E.coli were sensitive to Amikacin, Gentamicin, Piperacillin-Tazobactum, Tetracyclines, Nitrofurantoin & Carbapenams. E.coli exhibited resistance to cephalosprins and Fluroquinolones. 50 strains among the 87 isolates showed ESBL production by Phenotypic Confirmation Disc Diffusion Test (PCDDT) Discussion: E.coli has established itself as a strong uropathogen. E.coli infections are more common in females due to anatomical factors. Most of the uncomplicated urinary tract infections happen in females of child bearing age group. There is an urgent need for the formulation of antibiotic policy for initiation of presumptive treatment. The way forward to handle antibiotic resistance is implementation of safe hands policy with handwashing, well informed usage of antibiotics for an appropriate duration along with implementation of universally accepted infection control protocols. Keywords: Antibiotic policy Antibiotic resistance, PCDDT, Uropathogenic E.coli, Urinary Tract Infection.