High prevalence of multidrug resistance in bacterial uropathogens from Kathmandu, Nepal

Abstract

BackgroundUrinary Tract Infection (UTI) is one of the most common infectious diseases and people of all age-groups and geographical locations are affected. The impact of disease is even worst in low-resource developing countries due to unaware of the UTIs caused by multidrug-resistant (MDR) pathogens and the possibility of transfer of MDR traits between them. The present study aimed to determine the prevalence of MDR bacterial isolates from UTI patients, the antibiotic resistance pattern and the conjugational transfer of multidrug resistance phenotypes in Escherichia coli (E. coli).ResultsTwo hundred and nineteen bacterial isolates were recovered from 710 urine samples at Kathmandu Model hospital during the study period. All samples and isolates were investigated by standard laboratory procedures. Among the significant bacterial growth (30.8%, 219 isolates), 41.1% isolates were MDR. The most prevailing organism, E. coli (81.3%, 178 isolates) was 38.2% MDR, whereas second most common organism, Citrobacter spp. (5%, 11 isolates) was found 72.7% MDR. Extended-spectrum β-lactamase (ESBL) production was detected in 55.2% of a subset of MDR E. coli isolates. Among the 29 MDR E. coli isolates, plasmids of size ranging 2-51 kb were obtained with different 15 profiles. The most common plasmid of size 32 kb was detected in all of the plasmid-harbored E. coli strains. The majority of E. coli isolates investigated for the multidrug resistance transfer were able to transfer plasmid-mediated MDR phenotypes along with ESBL pattern with a frequency ranging from 0.3 × 10-7 to 1.5 × 10-7 to an E. coli HB101 recipient strain by conjugation. Most of the donor and recipient strain showed high levels of minimum inhibitory concentration (MIC) values for commonly-used antibiotics.ConclusionsThe high prevalence of multidrug resistance in bacterial uropathogens was observed. Particularly, resistance patterns were alarmingly higher for amoxycillin, co-trimoxazole, flouroquinolones and third-generation cephalosporins, which necessitate the re-evaluation of first and second line therapies for UTI. In addition, conjugational co-transfer of MDR phenotypes with ESBL-positive phenotypes was observed in MDR E. coli.

Multi Drug Resistant Pathogens Causing Urinary Tract Infections in Children at Kathmandu Model Hospital

“…Of the 33 MDR isolates, 27(45.0%) were E. coli. This result was supported by previous other studies 21,22,23 . Our study demonstrated the highest resistance to Ceftriaxone (94.12%) among 17 MDR isolates.…”

Characteristics of Urinary Tract Infections in Patients with Spinal Cord Injuries Hospitalized at a Rehabilitation Centre

“…The prevalence of UTIs was 41.7% in the present study, supporting previously reported results (3,4). Most frequently, E. coli, P. aeruginosa, or K. pneumoniae are isolated in urine cultures after a UTI develops (11,(16)(17)(18). E. coli was the most frequently detected uropathogen in our study, followed by P. aeruginosa and K. pneumoniae, findings that concurs with previous studies (11,(16)(17)(18).…”

Prevalence of multidrug resistant bacteria in causing community acquired urinary tract infection among the patients attending outpatient department of Seti Zonal Hospital, Dhangadi, Nepal

“…Our findings were consistent with the findings by Shrestha et al [5] who reported the culture positivity of 29.8% in females and 15.2% in males. In a similar study by Baral et al [6] the growth positivity was 33.5% among female patients and 23.7%, in male patients. This higher growth positivity seen in females was found to be statistically significant (p<0.05) and is due to their anatomical structure (short urethra and proximity to anal orifice) leading to easy access for enteric bacteria.…”