Antimicrobial Resistance Among Uropathogens: Surveillance Report From South India

Ravishankar, Uma; P, Sathyamurthy; Premamalini, Thayanidhi

doi:10.7759/cureus.12913

Cited by 8 publications

(12 citation statements)

References 28 publications

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“…Fortunately, less than 10% of resistance was observed for Nitrofurantoin, Fosfomycin, Amikacin, Imipenem, Meropenem and Colistin. These findings are similar to previous studies such as those by Uma Ravishankar et al 22 , MA Belete et al 25 and Daoud N et al 26 .…”

Section: Discussionsupporting

confidence: 93%

“…21 Many other studies have stated the preponderance of gram-negative organisms responsible for UTI with E. coli and Klebsiella occurring most frequently, similar to our study. 22 Diseases caused by drug resistant pathogens causes a mortality of around 700,000 people each year. Studies estimate this could swell to 10 million a year by 2050 if no action is taken 19 The increasing trend towards multi drug resistance (MDR) among uropathogens has become a serious global public health problem.…”

Section: Discussionmentioning

confidence: 99%

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Rising Resistance in Uropathogens With an Indication of Nitrofurantoin Mic Creep

Hasan

Garg

Nasimuddin³

et al. 2023

J Ayub Med Coll Abbottabad

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Background: The irrational use of antibiotics has led to the emergence of multi drug resistant pathogens. The phenomenon of MIC creeps occurs when organisms start showing raised MIC but within susceptible range giving an indication of the prevalence of rise in resistant pathogens in an area Methods: A cross sectional study in a large tertiary care hospital in North India to observe the susceptibility pattern among uropathogens and the possibility of MIC creeps. The Antimicrobial Susceptibility Testing (AST) and Minimum Inhibitory Concentration (MIC) were conducted by Vitek Compact 2. The identification of Extended Spectrum Beta Lactamase (ESBL) producers and Carbapenem Resistant Enterobacteriaceae (CRE) among Escherichia coli were noted. The MIC 50 and MIC 90 for Nitrofurantoin, the most widely used antibiotic for lower UTI, was calculated to investigate the phenomenon of MIC creep. Results: In our study, a total of 2522 urine samples were analyzed:1538 (61%) were positive with the commonest isolate being E. coli (n=736, 47.8%) followed by Klebsiella spp. (n=178, 11%). Less than 10% of resistance was observed for Fosfomycin, Amikacin, Nitrofurantoin, Imipenem, Meropenem and Colistin. ESBL producers and CRE E. coli were 528 (72% of 736) and 79 (11% of 736) respectively. Overall, 119/736 samples had an MIC ≥128. Amongst the ESBL producers, 96/528 had MIC ≥ 128 and amongst the CRE, 13/79 had MIC ≥ 128. Discussion: E. coli can be used to reflect the trends in development of resistance. In the current study, it was observed that E. coli showed a reduced susceptibility for Nitrofurantoin indicated by a creeping increase in MIC albeit within normal range. Conclusion: Trends in rising MIC should alert prescribers to use drugs such as Nitrofurantoin judiciously. Antimicrobial stewardship practices should be strongly implemented in hospitals to curb rising resistance and obtain better treatment outcomes for patients with infectious diseases.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Rising Resistance in Uropathogens With an Indication of Nitrofurantoin Mic Creep

Hasan

Garg

Nasimuddin³

et al. 2023

J Ayub Med Coll Abbottabad

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“…(Kornfält Isberg, et al 2019) This might contribute to the wider spectrum of bacteria in complicated UTIs. Following E. coli, E. faecalis accounted for up to 13.8% of the pathogenic bacteria in this study, similar to the findings of Ravishankar U et al (Ravishankar et al 2021) Regarding Enterococcus spp., there is a strong association between Enterococcus spp. and catheter-associated UTI.…”

Section: Discussionsupporting

confidence: 91%

Untitled

2023

Pak. J. Pharm. Sci.,

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To investigate the distribution characteristics and antibiotic resistance patterns of uropathogens in patients with upper urinary calculi and urinary tract infections, data on sex, age, positive midstream urine culture results and drug sensitivity results were collected. The statistical program SPSS 26.0 was used for statistical analysis. Among the 1414 positive urine samples, the most common pathogens were Escherichia coli (36.4%), Enterococcus faecalis (13.8%), Staphylococcus epidermidis (7.5%), Klebsiella pneumoniae (5.0%), Streptococcus agalactiae (3.4%) and Enterococcus faecium (3.3%). The incidences of E. coli (48.6%), K. pneumoniae (6.3%) and Proteus mirabilis (4.2%) were higher in female patients than in male patients (23.2%, 3.5%, 0.6%, respectively; P<0.05). E. faecalis was detected more frequently in the young group (16.0%) than in the elderly group (11.2%; P<0.01). Most of the isolates were resistant to levofloxacin and ciprofloxacin, while few were resistant to imipenem, meropenem, cefoperazone/sulbactam, piperacillin/tazobactam and amikacin. The bacterial spectra in patients with urinary stones varied by sex and age, which should be taken into consideration during treatment. The proportion of E. faecium showed an upward trend, while those of S. epidermidis and S. agalactiae demonstrated downward trends in the study period. Regardless, carbapenems, cefoperazone/sulbactam, piperacillin/tazobactam and amikacin are good choices for serious cases.

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“…10 It has been suggested that such high resistance of fluroquinolones and beta-lactams group of antibiotics are responsible for multidrug resistant (MDR) which leads to high selection rate of Extended spectrum beta-lactamase (ESBL) producing micro-organisms. 10,22,23 In studies, similar drug resistance pattern was seen in Escherichia coli isolates with high sensitivity to Nitrofurantoin and Beta-lactamase inhibitors. 4,13,16,22 It has been suggested by various studies that Nitrofurantoin is the most recommended drug for patients of UTI.…”

Section: Discussionmentioning

confidence: 77%

Uropathogens and their antibiotic susceptibility profile in a tertiary carehospital

Agarwal

Srivastava²,

Bose³

et al. 2021

IJMR

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Urinary tract infections (UTI) are one of the most common infections in the community and hospitals. Uropathogens colonize the urinary tract and may ascend to bladder causing cystitis, if left untreated reach kidneys through ureters can be responsible for acute pyelonephritis and cause renal damage. The aim of the present study is to determine the prevalence of urinary tract infections and antibiotic susceptibility pattern in a tertiary care hospital.This is an observational study conducted in Microbiology department, Hind Institute of Medical Sciences, Barabanki.A total of 623 urine(mid-stream) samples were collected from indoor and outdoor departments of hospital and culture was done on UTI chromogenic agar using semiquantitative method. Antibiotic sensitivity test was performed using Kirby Bauer disc diffusion method.Prevalence of urinary tract infections is 29% in the study. (43%) is the most common micro-organism isolated followed by (13%), (11%), (10.4%), (8.8%), (3.3%), (1.6%), CONS & (1.1%) and (6.6%). The females(56.6%) are more commonly affected than males.In the present study, beta-lactamase inhibitors and aminoglycosides were effective drugs against gram negative bacteria. Vancomycin and linezolid were sensitive in gram positive bacteria. Nitrofurantoin is the promising drug in cases of uncomplicated UTI, and safe to use in pregnancy. High recurrence rates and antimicrobial resistance are responsible for increasing the burden of disease. It is advised to use the antibiotics judiciously as per the hospital antibiotic policy which will help prevent multidrug resistance micro-organism further reducing morbidity and mortality.

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Antimicrobial Resistance Among Uropathogens: Surveillance Report From South India

Cited by 8 publications

References 28 publications

Rising Resistance in Uropathogens With an Indication of Nitrofurantoin Mic Creep

Rising Resistance in Uropathogens With an Indication of Nitrofurantoin Mic Creep

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Uropathogens and their antibiotic susceptibility profile in a tertiary carehospital

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