DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20160330

Antimicrobial sensitivity pattern among clinical isolates of Escherichia coli in tertiary care centre of Northern India

Ranjana Malhotra, Rama Sikka, Uma Chaudhary

Abstract


Background: Rampant rise in resistance to various antimicrobials among clinical isolates of Escherichia coli is an issue of serious concern, especially in developing countries. It not only causes failure in treatment but also pose a health burden over the society at large.

Methods: Antimicrobial susceptibility testing was performed by Kirby-Bauer disc diffusion method on Muller Hinton agar as per Clinical and Laboratory Standard Institute recommendations over 100 isolates of E. coli. Isolate resistant to at least three classes of antimicrobial agents was considered as multidrug resistant. Isolate resistant to the three classes of antimicrobials along with carbapenem was considered extensively drug resistant.

Results: On performing the antimicrobial sensitivity pattern it was observed that E. coli isolates were maximally sensitive to ertapenem (56%), followed by imipenem (44%), meropenem (41%), piperacillin-tazobactam (23%), amoxicillin-clavulanic acid (21%), aztreonam (18%) among β-lactams group of antibiotics. 41% E. coli isolates were multidrug resistant and 11% were extensively drug resistant isolates.

Conclusions: Stringent measures should be undertaken to curb the spread of antibiotic resistance. Policies should be framed and implemented to stop over the counter sale of antibiotics.

 


Keywords


E. coli, Multidrug resistant, Urinary tract infection, Extensively drug resistant, Beta lactams, Antibiotic sensitivity

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References


Farmer JJ, Boatwright KD, Janda M. Enterobacteriaceae: introducion and identification. In: MurrayPR., Baron EJ, Jorgensen JH, Landry ML, Pfaller MA.Manual of clinical microbiology. 9th ed. Washington DC: American Society for Microbiology. 2007:649-69.

Donnenberg MS. Escherichia coli: virulence mechanism of a versatile pathogen. San Diego: Academic Press. 2002:417.

Crichton PB. Enterobacteriaceae: Escherichia, Klebsiella, Proteus and other genera. In: Collee JG, Fraser AG, Marmion BP, Simmons A. Mackie and McCartney practical medical microbiology. 14th ed. India: Churchill Livingstone. 2012:364-5.

Kalantar D, Mansouri S. Emergence of multiple β-lactamases produced by Escherichia coli clinical isolates from hospitalized patient in Kerman, Iran. Jundishapur J Microbiol. 2010;3:137-45.

Taneja N, Rao P, Arora J, Dogra A. Occurrence of ESBL & Amp-C b-lactamases & susceptibility to newer antimicrobial agents in complicated UTI. Indian J Med Res. 2008;127:85-8.

Grover N, Sahni AK, Bhattacharya S. Therapeutic challenges of ESBLs and AmpC beta-lactamase producers in a tertiary care center. Medical Journal Armed Forces India. 2013;69:4-10.

Philippon A, Arlet G, Jacoby GA. Plasmid-determined AmpC-type β-lactamases. Antimicrob Agents Chemother. 2002;46:1-11.

Fukuda H, Hiramatsu K. Mechanisms of endogenous drug resistance acquisition by spontaneous chromosomal gene mutation. Nihon Rinsho. 1997;55:1185-90.

Datta S, Wattal C, Goel N, Oberoi JK, Raveendran R, Prasad KJ. A ten year analysis of multi-drug resistant blood stream infections caused by Escherichia coli&Klebsiella pneumoniae in a tertiary care hospital. Indian J Med Res. 2012;135:907-12.

Altun Ş, Tufan ZK, Yağcı S, Önde U, Bulut C. Extended spectrum beta-lactamases, AmpC and metallo beta-lactamases in emerging multi-drug resistant gram-negative bacteria in intensive care units. Scientific Reports. 2013;2(4):1-4.

Rahbar M, Deldari M, Hajia M. Changing prevalence and antibiotic susceptibility patterns of different Shigella species in Tehran, Iran. Int J Microbiol. 2007;3:2.

Lockhart SR, Abramson MA, Beekmann SE, Gallagher G, Riedel S, Diekema DJ. Antimicrobial resistance among gram-negative bacilli causing infections in intensive care unit patients in the United Statesbetween 1993 and 2004. J Clin Microbiol. 2007;45:3352-9.

Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility test. Twenty first international supplement. CLSI document M100-S21. Wayne PA. 2011.

Winn WC, Allen SD, Janda WM, Koneman EW, Procop GW, Schrekenberger PC. Koneman’s color atlas and textbook of diagnostic microbiology.6th ed. Philadelphia:Lippincott Williams and Wilkins. 2006:946-1014.

Manchanda V, Sanchaita S, Singh NP. Multidrug resistant Acinetobacter. J Global Infect Dis. 2010;2(3):291-304.

Wiedemann B, Heisig A, Heisig P. Uncomplicated urinary tract infections and antibiotic resistance-Epidemiological and mechanistic aspects. Antibiotics. 2014;3:341-52.

Chika E, Malachy U, Ifeanyichukwu I, Peter E, Thaddeus G, Charles E. Phenotypic detection of Metallo-β-Lactamase (MBL) enzyme in Enugu, Southeast Nigeria. American Journal of Biological Chemical and Pharmaceutical Sciences. 2014;2(2):1-6.

Tanvir R, Hafeez R, Hasnain S. Prevalence of multiple drug resistant Escherichiacoli in patients of urinary tract infection registering at a diagnostic laboratory in Lahore, Pakistan. Pakistan J Zool. 2012;44(3):707-12.

Al-salamy AK. Detection of extended spectrum-beta lactamase enzymes producing E. coli that isolated from urine. Kufa Journal for Veterinary Medical Sciences. 2012;3(1):55-66.

Messai Y, Benhassine T, Naim M, Paul G, Bakour R. Prevalence of β-lactams resistance among Escherichia coli clinical isolates from a hospital in Algiers. Rev Esp Quimioterap. 2006;19(2):144-51.

Enwuru NV, Enwuru CA, Ogbonnia SO, Adepoju-Bello AA. Metallo-β-lactamase production by Escherichia coli and Klebsiella species isolated from hospital and community subjects in Lagos, Nigeria. Nature and Science. 2011;9(11):1-5.

Bora A, Ahmed GU, Hazarika NK. Phenotypic detection of extended spectrum β-lactamase and AmpC β-lactamase in urinary isolates of Escherichia coli at a tertiary care referral hospital in Northeast India. Journal of College of Medical Sciences-Nepal. 2012:8(3):22-9.

Mirzaee M, Owlia P, Mansouri S. Distribution of CTX-M β-lactamase genes among Escherichia coli strains isolated from patients in Iran. Lab Med. 2009;40(12):724-7.

Ranjini CY, Kasukurthi LR, Madhumati B, Rajendran R. Prevalence of multidrug resistance and extended spectrum beta-lactamases among uropathogenic Escherichia coli isolates in a tertiary care hospital in South India: An alarming trend. Community Acquir Infect. 2015;2:19-24.

Ibrahim ME, Bilal NE, Hamid ME. Increased multi-drug resistant Escherichia coli from hospitals in Khartoum state, Sudan. African Health Sciences. 2012;12(3):368-75.

Niranjan V, Malini A. Antimicrobial resistance pattern in Escherichia coli causing urinary tract infection among inpatients. Indian J Med Res. 2014;139:945-8.