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Category: Volume 08 Issue 12 December 2020
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Title: Phenotypic detection and antibiotic susceptibility pattern of ESBL producing Escherichia coli from UTI patients at a tertiary care hospital in Jaipur

Authors: Adya Chaturvedi, M.Sc., Rashmi Sisodia, PhD, Navya Sharma, Pursuing MBBS, Ashutosh Chaturvedi, MD, Monika Rathore, MD, Rajni Sharma, MD

 DOI: https://dx.doi.org/10.18535/jmscr/v8i12.44

Abstract

UTI caused by Escherichia coli (E. coli) is reportedly the most common infection. According to current knowledge, antimicrobial resistance of these gram-negative bacteria especially to Beta-lactam antibiotics, further add on to the problem. Extended-Spectrum beta-Lactamase (ESBL) producing E. coli in urine cannot be detected by routine disk diffusion susceptibility test, which may lead to inappropriate use of antibiotics and thus ineffective treatment. The aim of this study was thus to determine the susceptibility pattern and phenotypic detection of ESBL producing E. coli from UTI patients. A total of 247 E. coli isolated insignificant number from UTI patients were included in the study and identified by conventional biochemical tests as per laboratory protocol. Antimicrobial susceptibility testing was performed by Kirby Bauer's disc diffusion method for ten antibiotics of different groups. Isolates showing resistance to third-generation cephalosporin were further tested for confirmation of ESBL production by Double disc approximation test, combined disc diffusion test and confirmed by ESBL E-test. During the study period 6084 urine samples from suspected UTI patients were tested. 56% (3397) were found to be caused by E. coli. Out of which 247 E. coli isolates chosen for the study. 20% were found to be ESBL producers by various phenotypic methods. The majority of the isolates were from males i.e., 53.8% (133) and females were 46.2% (114). UTI was observed highest amongst outpatients (61.9%) followed by various IPD wards (34.8%) and ICUs (0.3%). Among the isolates high degree of resistance was seen against Norfloxacin (81.7%), ciprofloxacin (77.7%) followed by amoxyclav (70.4%). Results indicate that UTI due to ESBL producing E. coli is common in the community. Thus, routine ESBL detection should be made compulsory not only in indoor patients but in outdoor patients also.

Keywords: UTI, Escherichia coli, Extended spectrum beta lactamase, 3rd Generation Cephalosporins, Antimicrobial susceptibility.

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Corresponding Author

Dr Rajni Sharma

Department of Microbiology, SMS Medical College, Jaipur, Rajasthan