BACKGROUND Urinary Tract Infection (UTI) caused by Escherichia coli (E. coli) has become a significant global public health problem. The resistance to β-lactam antibiotics in E. coli further adds to the problem. The pattern of drug resistance among E. coli undergoes considerable variation and consequently the treatment of Urinary Tract Infection (UTI) requires constant updating of the antibiotic sensitivity profile. The study was thus undertaken to know resistance pattern of E. coli isolates with special reference to production of extended spectrum β-lactamases (ESBLs) in urinary samples. MATERIALS AND METHODS This is a three-year (2015-2017) retrospective descriptive study undertaken in Srinivas Institute of Medical Sciences and Research Centre, Mukka, Mangalore. Standard culture techniques for urine samples were followed. Antibiotic sensitivity test was done by Kirby-Bauer disc diffusion method and interpretation was done following Clinical and Laboratory Standards Institute (CLSI) guidelines. ESBL detection was done by NCCLS phenotypic confirmatory combination disc diffusion method using ceftazidime (30 μg) alone and ceftazidime + clavulanic acid (30 μg/ 10 μg). RESULTS E.coli is the most frequent isolate found in UTI (65.4% of total isolates) throughout three years. The overall resistance pattern of E.coli exhibited highest resistance against ampicillin (95%) and amoxyclav (83.3%) with rising trend in resistance to Cephalosporins and Quinolones in three successive years. The rising trend in ESBL production rate was observed from 27.3% (2015) to 39.4% (2017) with least resistance against meropenem (9.9%), piperacillin/ tazobactam (10%), nitrofurantoin (11.4%) and amikacin (12.1%). It was also observed that > 50% of ESBL producing E. coli isolates exhibited resistance against cotrimoxazole and Quinolones. CONCLUSION The incidence of the ESBL producing E. coli has been steadily increasing over the past few years. The knowledge on the resistance pattern in a geographical area will help in guiding the appropriate and the judicious use of antibiotics.
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