The present study was conducted to track down commonest gram negative bacilli along with their pattern of resistance to antibiotics from various clinical specimens, from patients admitted to intensive care unit. A total of 182 clinical specimens were analyzed using standard techniques. Out of 182 specimens 105 were culture positive, whereas the remaining 77 were culture negative. From 105 culture positive specimens 65 (61.90%) showed growth of gram negative bacilli, remaining 40 (38.09%) with growth of gram positive organisms. In this study E .coli was found to be the predominant isolate with 44.61% rate of isolation, followed by Klebsiella pneumoniae 15.38%, rate of isolation of Proteus mirabilis, Citrobacter fruendii each accounting for 9.23%. Pseudomonas aeruginosa 7.69%, Proteus vulgaris 3.07%, Acinetobacter species and Salmonella typhi accounted for 1.53 % each. To conclude, aerobic gram negative bacilli were predominant clinical isolates from patients admitted to intensive care unit. Amikacin and gentamicin were found to be effective antibiotics against gram negative bacilli in this particular setting.
Urinary tract infection (UTI), is defined as a disease caused by invasion of urinary tract by microorganisms. Majority of UTI cases are due to bacterial infection constitute about 95% of total UTI cases. About 80% of UTI cases are caused by E.coli producing extended spectrum ?-lactamase (ESBL) producing isolates. In recent years limitations in treating infections caused by multidrug resistant organisms has increased. This study aims to determine ESBL production of E. coli cases from a tertiary care hospital. Methodology: A total 358 midstream urine samples were collected by random sampling method during March 2015 to June 2018. Identification, antibiotic sensitivity testing, performed according to standard protocol following Clinical and Laboratory Standard Institute (CLSI) guidelines, 2013. Screening for ESBL producing E.coli isolates performed using ceftazidime further confirmation done by phenotypic disc diffusion test using combined disc method using ceftazidime (30µg) & ceftazidime/ clavulanic acid (30/10 µg) as per CLSI guidelines. Results: Total 358 specimens processed for urine culture. Gram negative bacilli isolated from 123(34.35 %), out of which 68 (55.28%) were E.coli, 19 (15.44%) K. pneumoniae, 15 (12.19%), Pseudomonas spp. 08 (6.50%), Citrobacter spp and Acinetobacter spp, 03 (2.43%), Proteus mirabilis, 01 (0.81%) Proteus vulgaris and Enterobacter respectively. Out of 68 isolates of E.coli, 65 (95.58%) were MDR, ESBL was detected in 31 (47.69%) out of these 65 isolates. Out of these 31 cases 19 (61.29%) were female and 12 (38.70%) were male cases. Conclusion: This study concludes 47.69% ESBL producing MDR E. coli were isolated from UTI cases with female predominance.
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