Antibiotic resistance of E. coli isolates from urine samples of Urinary Tract Infection (UTI) patients in Pakistan

Jafri, Saghir Ahmad; Qasim, Muhammad; Masoud, Muhammad Shareef; Rahman, Mahmood-ur; Izhar, Mateen; Kazmi, Saqib

doi:10.6026/97320630010419

Cited by 22 publications

(16 citation statements)

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“…AMs, especially fluoroquinolones, are frequently prescribed in GIT infections (bacterial origin) to lessen the severity of infection and to minimize other symptoms [ 35 ]. Patients suffering from UTI are frequently prescribed with cephalosporins and penicillins [ 36 ]. Acute bronchitis is mostly caused by bacteria and viruses and AMs are prescribed to reduce the duration of cough and other symptoms [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

Antimicrobial use by WHO methodology at primary health care centers: a cross sectional study in Punjab, Pakistan

et al. 2018

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BackgroundTo investigate the antimicrobial (AM) use and prescribing patterns at primary health care centers (PHCCs) in Punjab, Pakistan.MethodsA cross-sectional study was designed according to the World Health Organization (WHO) methodology for AM usage from January, 2017 to June, 2017. Standard data collection forms designed by the WHO were used to collect the data from 32 PHCCs (16 rural healthcare centers (RHCs) and 16 basic health units (BHUs)) in Punjab province of Pakistan. PHCCs were randomly selected from 8 main cities. The study sample consisted of prescription records of 6400 outpatients (200 prescriptions records from each PHCC) and 800 inpatients (25 inpatient records from each PHCC). Data of the year 2016 were collected retrospectively by using systematic random sampling technique and analyzed through SPSS.ResultsAmong the hospital indicators, standard treatment guidelines (STGs) regarding the infectious diseases were not available in PHCCs. Number of days during which key AMs were out of stock was 12.1 days per month (range = 3.1–19.2). Out of total PHCC medicines costs, expenditures on AMs were 26.2% (range = 17.1–39.0). In case of prescribing indicators, the average number of AMs per prescription was 1.4 (range = 1.1–1.7), percentage of prescriptions prescribed with AMs was 81.5% (range = 68.9–89.1) and duration of AM treatment on average was 5.1 days per patient (range = 3.3–6.4). Average cost of prescribed AMs per patient was 1.3 USD (range = 0.6–4.3). The PHCCs prescribed a median of 5 (range = 3–9) types of AMs, including 10 (range = 5–15) individual agents. Out of 79.3% prescriptions of outpatients prescribed with AMs, only 16.4% were properly prescribed. Out of 100% prescriptions of inpatients prescribed with AMs, 12.1% were properly prescribed. Out of all the AM prescriptions 23.6% contained penicillins, 20.1% contained cephalosporins and 19.4% contained fluoroquinolones Metronidazole (18.0%), ciprofloxacin (16.5%) and co-amoxiclav (14.3%) were most commonly prescribed AMs.ConclusionsIn PHCCs, AMs were prescribed more frequently. However large proportions of these prescriptions were inappropriate. Continuous education and training of medical staff and cost effective policies could play an important role in promotion of rational use of AMs.Electronic supplementary materialThe online version of this article (10.1186/s12879-018-3407-z) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Antimicrobial use by WHO methodology at primary health care centers: a cross sectional study in Punjab, Pakistan

et al. 2018

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“…The rates of antibiotic resistance in our study were different from some studies in other countries. [ 18 34 35 36 37 ] MDR rate was higher in inpatients isolates (68%). A significant high resistance to SXT (61.2%) was found in the present study while many guidelines recommend this drug for UTIs.…”

Section: Discussionmentioning

confidence: 99%

High prevalence of multidrug-resistance uropathogenic Escherichia coli strains, Isfahan, Iran

et al. 2016

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Background and Objectives:Urinary tract infection (UTI) is one of the most frequent infectious diseases and can occur in all age groups. Escherichia coli is the main cause of this infection. Multiple resistances to antimicrobial agents are increasing quickly in E. coli isolates and may complicate therapeutic strategies for UTI. The aim of this study was to determine the antibiotic resistance pattern and the multidrug-resistance (MDR) phenotypes in uropathogenic E. coli (UPEC).Materials and Methods:A total of 135 UPEC isolates were collected from both outpatients (91 isolates) and inpatients (44 isolates) between September, 2012 and February, 2013. In order to determine the MDR among UPEC isolates, we have tested 15 antimicrobial agents and antibiotic susceptibility was done by Kirby-Bauer disk diffusion method.Results:The percentage of MDR isolates (resistant to at least three drug classes such as aminoglycosides, fluoroquinolones, penicillins, cephalosporins, or carbapenems) was 68% in the inpatients and 61% in the outpatients. Antibiotic resistance to ampicillin, ceftazidim, nalidixic acid, and trimethoprim/sulfamethoxazole were higher than 50%. Amikacin, nitrofurantoin, and gentamicin showed markedly greater activity (89.1%, 85.9%, and 82.4% sensitivity, respectively) than other antimicrobial agents. Resistance to meropenem did show either in outpatients or in inpatients.Interpretation and Conclusions:The high prevalence of drug resistance among UTI patients calls for continuous monitoring of the incidence of drug resistance for appropriate empiric selection of antibiotic therapy. Empirical treatment of UTIs should be relied on susceptibility patterns from local studies.

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“…Imipenem resistance rate to E coli is 32.5% in a study of Pakistan. [35] Another study in Bangladesh has shown Meropnem resistance rate to E coli is 10.5%. [36] Antibiotics resistance depends on the genetic mutation and locality.…”

Section: Discussionmentioning

confidence: 99%

Pattern of Antimicrobial Resistance to <i>Escherichia Coli</i> Among the Urinary Tract Infection Patients in Bangladesh

Acherjya¹

2018

AJIM

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Urinary Tract Infection (UTI) is very common in our day-today clinical practice. Among all the organisms Escherichia coli (E coli) is the most common but antimicrobial resistance becomes an alarming issue for UTI management now a days. Aim of this study is to assess the pattern of antimicrobial resistance to E coli among the UTI patients in Jashore, Bangladesh. This observational study was conducted from February, 2017 to January, 2018 in the district of Jashore, Bangladesh. We recruited 696 patients of both sex with UTI only infected by E coli. We had excluded the patients with UTI caused by other than E coli, female during menstruation, pregnancy, history of taking antibiotics within last 21 days, catheterization within 1 month and pelvic organ & genito urinary tract surgery within 6 months. Evaluation of antimicrobial resistance was done according to the standard bacteriological methods. Mean age of our study cases was 41.46±17.21 years with the range from 15 to 91 years. More than 85% participants were female with a sex ratio was 8:1.5. Reproductive age group ranged from 21 to 50 years was affected most commonly which constituted approximately two-third of our study. Our study revealed that the maximum antimicrobial resistance to E coli was Cotrimoxazole (95.0%), followed by Ceftazidime (75.7%), Gentamicin (70.3%), Amikacin (69.0%), Imipenam (58.9 %,), Cefixime (58.0%), Ciprofloxacin (57.3%), Azithromycin (56.0%), Cefuroxime (46.6%), Cefotaxime (37.4%), Ceftriaxone (35.2%), Meropenem (32.2%), Nitrofurantion (4.7%). With the high magnitude of antimicrobial resistance to E coli among the UTI patients even with extended generation of Cephalosporins, Carbapenams, Ciprofloxacin, Cotrimoxazole, Azithromycin and Aminoglycosides, our recommendation as first line empirical treatment option in UTI should be Nitrofurantoin due to low resistance pattern.

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Antibiotic resistance of E. coli isolates from urine samples of Urinary Tract Infection (UTI) patients in Pakistan

Cited by 22 publications

References 13 publications

Antimicrobial use by WHO methodology at primary health care centers: a cross sectional study in Punjab, Pakistan

Antimicrobial use by WHO methodology at primary health care centers: a cross sectional study in Punjab, Pakistan

High prevalence of multidrug-resistance uropathogenic Escherichia coli strains, Isfahan, Iran

Pattern of Antimicrobial Resistance to <i>Escherichia Coli</i> Among the Urinary Tract Infection Patients in Bangladesh

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Antibiotic resistance of E. coli isolates from urine samples of Urinary Tract Infection (UTI) patients in Pakistan

Cited by 22 publications

References 13 publications

Antimicrobial use by WHO methodology at primary health care centers: a cross sectional study in Punjab, Pakistan

Antimicrobial use by WHO methodology at primary health care centers: a cross sectional study in Punjab, Pakistan

High prevalence of multidrug-resistance uropathogenic Escherichia coli strains, Isfahan, Iran

Pattern of Antimicrobial Resistance to &lt;i&gt;Escherichia Coli&lt;/i&gt; Among the Urinary Tract Infection Patients in Bangladesh

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Pattern of Antimicrobial Resistance to <i>Escherichia Coli</i> Among the Urinary Tract Infection Patients in Bangladesh