Escherichia coli (E.coli), a common human intestinal commensal causes infections in bodily sites outside the gastrointestinal tract and are called Extra-intestinal pathogenic E.coli. ExPEC causes Urinary tract infections, Blood stream infections, Pneumonia, meningitis,bone, skin, and soft tissue infections including both nosocomial and community acquired infections. The increasing trend of developing antibiotic resistance in ExPEC is of global treat which causes increasing morbidity and mortality.As there is no vaccination forExPEC so it is necessary to analyze the antibiotic susceptibility pattern for empirical treatment in emergency situations.Extended spectrum beta lactamases (ESBLs) hydrolyze β-lactam antibiotics of third generation Cephalosporins, Penicillins and Monobactams. Since the ESBL enzyme genes are usually found in large plasmids, they also contain other antimicrobial resistant genes.AmpC production in E.coli is through plasmids and mutation in their porin structure. Carbapenems are the drug of choice for ESBL producing Ecoli but recent time development of resistance is increasingly reported due to production of Carbapenemase.The aim of this study is to test the Antimicrobial susceptibility pattern of Extra-intestinal Ecoli isolates. The study was conducted in the department of Microbiology, Stanley Medical College, Chennai during the period October 2018 to May 2019.The institutional ethical committee approval was obtained and clinical samples such as urine, blood, pus, sputum and sterile body fluids were received from 983 patients suspected of bacterial infections. The samples were processed and biochemical test identified 84 Ecoli Isolates. Antimicrobial testing, ESBL, AMPC screening and carbapenemase production were tested. E.coli isolates showed resistance to most of the beta lactam antibiotics such as Ampicillin, CefotaximeandCeftazidime and also to Ciprofloxacin &Cotrimoxazole.
Skin and soft tissue infections (SSTIs) are commonly occurring infections with mild to serious clinical manifestations. The incidence of wound sepsis in India ranges from 10-33%1,2. It is important to know the potential microbial pathogens causing wound infections for clinicians to start empirical treatment for patients, while laboratory culture reports are awaited. To identify the common microorganisms and their antimicrobial resistance pattern in pus samples. A total of 8656 pus samples were received in the Microbiology department from various OP and IP departments of Stanley Medical College Hospital, Chennai. The samples were processed in the laboratory for aerobic culture to isolate the pathogens and to perform antibiotic sensitivity testing as per standard protocol31. This prospective study was done for a period of twelve months (Jan 2018 to Dec.2018). Growth was observed in 5793 samples (66.92%), while growth was absent in 2863 samples (33.07%). Of the culture positive samples, 250 (4.31%) showed mixed infection, while 5543 samples (95.68%) yielded a single isolate. In this study, among the isolates (6043 in number), 5965 (98.70%) were bacterial and 78 (1.29%) were fungal. The most common bacterial isolate was Pseudomonas species(27.42%), followed by Staphylococcus aureus (15.60%), Klebsiella pneumoniae (11.95%), Escherichia coli (9.53%), Coagulase negative Staphylococci (9.22%) and Acinetobacter spp. (8.65%). Among the S.aureus isolates, 59% were Methicillin resistant and 41% were Methicillin sensitive. The fungal isolates were Candida spp. ( 80.76%) and Aspergillus spp. (19.24%). The common pathogens isolated in this study were Pseudomonas species (27.42%), Staphylococcus aureus (15.60%) and Klebsiella pneumoniae (11.95%). The increased incidence of antimicrobial-resistant microorganisms like Methicillin-resistant S. aureus, ESBL and MBL producers causes great global concern leading to more difficulty to treat infections and death.
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