A Study on Antibiotic Susceptibility Pattern of Escherichia Coli Isolates From Extra Intestinal Infections in a Tertiary Care Hospital

Abstract

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.

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“…Extended-spectrum beta-lactamases (ESBLs) are responsible for resistance to β-lactam antibiotic, which are plasmid-mediated and easily transmitted among Enterobacteriaceae members 11,12 . Carbapenem drugs have been introduced in clinical settings to overcome resistance to ESBLs.…”