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Isolation And Characterization Of Multidrug Resistant E. Coli From Urinary Tract Infections In A Tertiary Care

By: Sumera Sabir | Dr. Aftab Ahmad Anjum.
Contributor(s): Dr | Dr. Muhammad Asad Ali.
Material type: materialTypeLabelBookPublisher: 2013Subject(s): Department of MicrobiologyDDC classification: 1687,T Dissertation note: Bacterial etiology of urinary tract infections (UTIs) admitted in or visiting a tertiary care hospital in Lahore, Pakistan was determined by conventional biochemical profile. Multiple drug resistance (MDR) of Escherichia coli, the most prevalent bacteria, was checked. Overall bacterial prevalence recorded was 80.4 percent, being highest in patients of intensive care unit (93%) followed by urology ward (87%), north surgical ward (85%), east medical ward (70%) and OPD (67%). Infection rate was higher in female (87.5%) than male (71.3%) and almost same in pregnant (86%)/non-pregnant (88%) female patients. Highest percent UTIs observed were in patients of 51-75 years of age. Percent infection recorded in catheterized patients (70.8%) was lower than non-catheterized (83%) and little higher in Diabetics (82%). Out of biochemically identified bacterial isolates (n=402), highest number was of E. coli 321 (80%) followed by Staphylococcus aureus 38 (9.4%), Proteus species 22 (5.4%) and Pseudomonas species 21 (5.2%). Almost same pattern of isolation was observed among patients of different wards. On statistical analysis significantly higher number of E. coli was observed among isolates from patients of five wards included in study plan. Out of bacterial isolates from male (n=157) and female (n=245) patients highest prevalence was of E. coli (79% and 80%). Out of total bacterial isolates from female patients (n=245), number of was E. coli at the highest rank 90 (79.6%), in pregnant. Among different age groups highest prevalence was of E. coli and lowest of Pseudomonas species. Out of 120 tested urine samples collected from catheterized patients bacterial growth was observed in 85. On bacterial identification by conventional biochemical characterization highest prevalence was of E. coli (56.4%). Out of pure bacterial cultures (n=70) from Diabetic patients highest number identified was of E. coli 54 (77.1%) followed by Staphylococcus aureus 8 (11.4%), Proteus 2 (2.8%) and 6 (8.57%) were Pseudomonas species. According to Antibiotic sensitivity testing results E. coli showed highest resistance to penicillin/amoxicillin (100%) followed by cefotaxime (89.7%), ceftazidime (73.8%), Cephradin (73.8%), tetracycline (69.4%), doxycycline (66.6%), augmentin (62.6%), gentamycin (59.8%), cefuroxime (58.2%), ciprofloxacin (54.2%), Cefaclor (50%), Aztreonam (44.8%), ceftriaxone (43.3%), imipenem (43.3%), streptomycin (30%), kanamycin (19.9%), Tazocin (14%), Amikacin (12.7%) and lowest to norfloxacin (11.2%). Out of 321 E. coli 261 (81%) were declared MDR being resistant to three or more antibiotic classes. Most of the urinary tract infections in human beings are caused by E. coli which show resistance to multiple antibiotics.
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Bacterial etiology of urinary tract infections (UTIs) admitted in or visiting a tertiary care hospital in Lahore, Pakistan was determined by conventional biochemical profile. Multiple drug resistance (MDR) of Escherichia coli, the most prevalent bacteria, was checked. Overall bacterial prevalence recorded was 80.4 percent, being highest in patients of intensive care unit (93%) followed by urology ward (87%), north surgical ward (85%), east medical ward (70%) and OPD (67%). Infection rate was higher in female (87.5%) than male (71.3%) and almost same in pregnant (86%)/non-pregnant (88%) female patients. Highest percent UTIs observed were in patients of 51-75 years of age. Percent infection recorded in catheterized patients (70.8%) was lower than non-catheterized (83%) and little higher in Diabetics (82%).
Out of biochemically identified bacterial isolates (n=402), highest number was of E. coli 321 (80%) followed by Staphylococcus aureus 38 (9.4%), Proteus species 22 (5.4%) and Pseudomonas species 21 (5.2%). Almost same pattern of isolation was observed among patients of different wards. On statistical analysis significantly higher number of E. coli was observed among isolates from patients of five wards included in study plan. Out of bacterial isolates from male (n=157) and female (n=245) patients highest prevalence was of E. coli (79% and 80%). Out of total bacterial isolates from female patients (n=245), number of was E. coli at the highest rank 90 (79.6%), in pregnant.

Among different age groups highest prevalence was of E. coli and lowest of Pseudomonas species. Out of 120 tested urine samples collected from catheterized patients bacterial growth was observed in 85. On bacterial identification by conventional biochemical characterization highest prevalence was of E. coli (56.4%). Out of pure bacterial cultures (n=70) from Diabetic patients highest number identified was of E. coli 54 (77.1%) followed by Staphylococcus aureus 8 (11.4%), Proteus 2 (2.8%) and 6 (8.57%) were Pseudomonas species.
According to Antibiotic sensitivity testing results E. coli showed highest resistance to penicillin/amoxicillin (100%) followed by cefotaxime (89.7%), ceftazidime (73.8%), Cephradin (73.8%), tetracycline (69.4%), doxycycline (66.6%), augmentin (62.6%), gentamycin (59.8%), cefuroxime (58.2%), ciprofloxacin (54.2%), Cefaclor (50%), Aztreonam (44.8%), ceftriaxone (43.3%), imipenem (43.3%), streptomycin (30%), kanamycin (19.9%), Tazocin (14%), Amikacin (12.7%) and lowest to norfloxacin (11.2%). Out of 321 E. coli 261 (81%) were declared MDR being resistant to three or more antibiotic classes. Most of the urinary tract infections in human beings are caused by E. coli which show resistance to multiple antibiotics.

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