A Study of Antibacterial Susceptibility and Resistance Pattern of E. coli Causing Urinary Tract Infection in Chittagong, Bangladesh

Elmanama

et al. 2023

J Infect Dev Ctries

Introduction: Antimicrobial resistance (AMR) is a natural evolutionary process in bacteria that is accelerated by selection pressure from the frequent and irrational use of antimicrobial drugs. This study aimed to determine the variations in AMR patterns of priority bacterial pathogens at a tertiary care hospital in the Gaza Strip during pre- and post-COVID-19 pandemic. Methodology: This is a retrospective observational study to determine the AMR patterns of bacterial pathogens at a tertiary hospital in the Gaza Strip in the post-COVID-19 pandemic period compared to the pre-COVID-19 period. Positive-bacterial culture data of 2039 samples from pre-COVID-19 period and 1827 samples from post-COVID-19 period were obtained from microbiology laboratory records. These data were analysed and compared by Chi square test using Statistical Package for Social Sciences (SPSS) Program. Results: Gram-positive and Gram-negative bacterial pathogens were isolated. Escherichia coli was the most prevalent in both study periods. The overall AMR rate was high. There was a statistically significant increase in resistance to cloxacillin, erythromycin, cephalexin, co-trimoxazole and amoxicillin/clavulanic acid in the post-COVID-19 period compared to pre-COVID-19 period. There was also a significant decrease in resistance to cefuroxime, cefotaxime, gentamicin, doxycycline, rifampicin, vancomycin and meropenem in the post-COVID-19 period. Conclusions: During the COVID-19 pandemic, the AMR rates of restricted and noncommunity-used antimicrobials declined. However, there was an increase in AMR to antimicrobials used without medical prescription. Therefore, restriction on the sale of antimicrobial drugs by community pharmacies without a prescription, hospital antimicrobial stewardship and awareness about the dangers of extensive use of antibiotics are recommended.

Section: Discussionsupporting

confidence: 84%

Pre- and post-COVID-19 antimicrobial resistance profile of bacterial pathogens, a comparative study in a tertiary hospital

Elmanama

et al. 2023

J Infect Dev Ctries

“…10 Most number of positive urine cultures (54.16%) were seen in age group 20-40 years and most patients were female. This showed that UTI is common in reproductive age group which is comparable to study done by Banerjee et al 6 , obiogbolu et al 10 , shahina et al 11 . The most common organism isolated in our study was E. coli (91.66%) followed by K. pneumonae(6.99%) which is similar to a study done by Humayun et al 4 and Mansur et al 9 where E. coli(70% and 59%) followed by K. pneumonae( 14% and 11.6%) was isolated.…”

Section: Discussionsupporting

confidence: 87%

Bacteriological Profile and Antibiotic Sensitivity Pattern in Patients with Urinary Tract Infection in Janakpurdham, Nepal

Thakur¹,

Mahaseth²,

Sah³

2021

ijmsci

Background: Urinary tract infections are most common bacterial infection in routine clinical practice. It is also most common nosocomial infection in many hospitals. Antibiotics are usually given empirically before urine culture reports available and treatment failure rate used to be significantly high. Study of causative agents and their antimicrobial sensitivity pattern are important factors helping formulating antibiotic policy. Generally, most common uropathogene is Escherichia Coli. Tertiary care hospitals, catering of already partially treated or mal treated patients as major chunk, may have varying etiologies and different sensitivity patterns. Objective: To study the culture and sensitivity patterns of urinary tract infections in patients presenting with urinary symptoms in local hospitals. Study design: A cross sectional study Materials and methods: Study was conducted at Madanta Research Clinic Private Limited from 12th march 021 to 12th September 021. Urine from cases suspected to have symptoms suggestive of UTI were send for bacteriological culture and sensitivity. Demographic profiles of each participant along with pathogen isolated, culture sensitivity pattern was documented. Data analysis was done in IBM spss 25. Results: A total 200 samples were selected for bacteriological culture and sensitivity out of which 32% were male and 68% were female. Around 50% of participants were in age group 20-40. There was no growth in 64% sample. Among positive samples (36%), E. coli (most common) was detected in 91.66%, Klebsiella was detected in 6.94%. Gentamicin, Amikacin and Nitrofurantoin were most common antibiotics sensitive to organisms in culture and Cephalosporins group of antibiotics are commonly resistant. Conclusions: coli is the most common organism isolated in urine culture in our region Janakpur. Cephalosporins are resistant in majority of cases where as Aminoglycosides like Amikacin, Gentamicin and Nitrofurantoin are found to be highly sensitive in most of positive cases.

“…But Cefuroxime showed significant (mean p-value <0.001) level of sensitivity to E. coli. 11 A meta-analysis of around 25 studies with MDR UTI patients showed that major factor leading to MDR UTI was the miss use of antibiotics. This reported in 16 out of 20 studies.…”

Section: Discussionmentioning

confidence: 99%

Emerging antibiotic resistance pattern of urinary tract infection (UTI) due to Escherichia Coli (E.Coli).

Azhar

Munir²,

Ahmed

et al. 2021

TPMJ

Objective: To determine the emerging antibiotic resistance pattern of adult patients of MDR UTI cases caused by E.Coli. Study Design: Retrospective Data. Setting: Departments of Medicine and Obstetrics & Gynecology, Madinah Teaching Hospital / University Medical and Dental College, Faisalabad. Period: August 2016 to Sep 2018. Material & Methods: This retrospective study included 187 patients meeting the operational definition of multi-drug resistance cases of urinary tract infection caused by E. coli. All cases either male or female of age above 15 years with positive reports of urine culture and sensitivity for E.coli were included in the study. Along with the demographic variables urine WBC’s, results of urine culture and sensitivity were noted. Antibiotic sensitivity pattern of all the E.coli resistant UTI cases was analyzed. After identification of the microbe, antimicrobial sensitivity was accessed using Kirby–Bauer disc diffusion method on the Mueller–Hinton agar. The antimicrobial susceptibility test was performed against E. coli strains by using the following antibiotics: Piperacilin, Amoxicilin-Calvulanic, Pipmedic Acid, Cefipime, Ceftrixone, Cefuroxime, Cefoperazone-sulbactam, Ceftazidime, Cephradine, Ciprofloxacin, Ofloxacin, Levofloxacin, ofloxacin, Nitrofurantoin, Amikacin, Tombramycin, Gentamicin, Linezolid, Doxycycline, Sulphamethoxazole, Imipenem, Meropenem, Aztreonam in order to obtain an antibiogram. Results: In our data, 66.8% (n=125) were MDR UTI, and more than half of these cases were 63.2% (n=79) were females. Among the total 187 cases, 97.3% patients were resistant to most of the beta-lactam antibiotics, 95.7% were resistant to most of the quinolones and 68.4% were resistant to most of the aminoglycosides. Conclusion: This increasing antibiotic resistance is very alarming and steps should be taken to reduce the misuse of antibiotics. Studies should be done to control the risk factors leading to E. coli UTI. By following proper pharmacological guidelines, principles to use antibiotics and manage outpatient cases of UTIs, the incidence of MDR UTI can be controlled.