Prevalence, Distribution and Determinants of Escherichia Coli Resistance to Ceftriaxone in Adult Indoor Uti Population of District Peshawar, Pakistan (original) (raw)
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Zanjan University of Medical Sciences, 2020
Article Info ABSTRACT 10.30699/jambs.28.128.124 Background & Objective: Escherichia coli (E. coli) is considered to be the most common cause of urinary tract infections (UTIs) worldwide. Due to the recent rise in bacterial resistance to antibiotics and the appearance of multidrug-resistant E. coli, treatment options have been significantly limited, thus increasing the cost of treatment as well as morbidity and mortality rates, especially in developing countries. This study aimed to identify the antibiotic susceptibility patterns of E. coli for use in early empirical treatments and cultures of negative UTIs caused by previous antibiotic usage. Materials & Methods: In the present study, 704 urine samples with a positive culture of E. coli were evaluated in terms of susceptibility to gentamycin, nitrofurantoin, ceftazidime, cefixime, meropenem, cefepime, azithromycin, ceftriaxone and ciprofloxacin using the Kirby-Bauer disc diffusion method. Data were collected based on age, sex, and hospitalization or ambulatory patient status. Data were analyzed using SPSS 22.0. Results: E. coli showed the lowest resistance to nitrofurantoin (4.5%) and the highest resistance to cefixime (34.9%). There was a statistically significant relationship between antibiotic resistance and age, gender, and hospitalization status Conclusion: Because of the high resistance rate of E. coli to cefixime, precautions should be taken before using cefixime to treat UTIs.
American Journal of Internal Medicine, 2018
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.
DOAJ (DOAJ: Directory of Open Access Journals), 2022
Background and aims: Urinary tract infections (UTIs) are intense public health problems and are precipitated by a variety of pathogens. This study was performed to determine the frequency of bacterial agents of UTIs and the antibiotic resistance pattern of Escherichia coli in urinary culture samples of patients at Shahid Ashrafi Esfahani hospital in Tehran, Iran. Methods: A cross-sectional study was conducted on all urinary tract cultures from January 2021 to January 2022 at Shahid Ashrafi Esfahani hospital in Tehran, Iran. Urine culture and antimicrobial susceptibility tests were performed according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Statistical analyses were performed by appropriate descriptive and inferential tests such as the chi-square test using Stata version 17, and the level of significance was set at 0.05. Results: The mean age of patients with E. coli was 50.2 ± 1.8 (confidence interval = 46.6-53.8) years, and their age range was between 6-87 years. The highest prevalence of infection occurred in men over 60 years of age and in women aged 40-60 years. Further, the highest resistance and the highest sensitivity were related to ceftazidime (CAZ) and cefotaxime (CTX), respectively. Conclusion: In this study, the highest resistance and sensitivity belonged to CAZ and CTX, respectively. In addition, CTX is the primary antibiotic prescribed to deal with UTIs in medical practice.
International Journal of Research in Medical Sciences, 2023
Background: Multi-drug resistant organisms, particularly in urinary tract infections, have become a significant concern in developing countries like Bangladesh. Physicians are facing challenges in treating hospitalized cases due to the ineffectiveness of conventional antibiotics and empirical treatment, as well as the emergence of multi-drug-resistant Escherichia coli. The main goal of the study was to observe the prevalence and resistant pattern of multidrug-resistant Escherichia coli urinary tract infections among patients admitted to a teaching hospital. Methods: The cross-sectional study was conducted between August 2011 to February 2012 at Uttara Adhunik Medical College Hospital (UAMCH), Dhaka, Bangladesh. It included 100 cases, and detailed information was obtained through a standardized protocol. Results: In a study of 100 UTI patients, 45 had MDR E. coli while 55 had non-MDR E. coli. Females accounted for 79% of the patients, with a mean age of 44.85±17.81 years. The majority of participants fell into the 31-40 years age group (28%) and 60 years age group (23%). Among the participants, 57% had a history of UTI while 43% had no previous UTI history. High resistance was observed against amoxicillin, amoxiclav, cephradine, cefuroxime, cefixime, ceftriaxone, ceftazidime, and nalidixic acid. However, ciprofloxacin (2.22%), levofloxacin (6.67%), and cotrimoxazole (31.11%) exhibited lower resistance rates among MDR samples. Imipenem and meropenem showed 100% effectiveness against all MDR samples. Conclusion: MDR E. coli rates were alarmingly high in a teaching hospital in Bangladesh. Excessive antimicrobial drug consumption globally has led to antibiotic-resistant E. coli isolates, posing challenges for effective UTI treatment worldwide. Antibiotic therapy remains crucial in controlling these invasive agents.
Tropical Journal of Pharmaceutical Research, 2008
Purpose: This paper was mainly aimed to investigate drug resistance of the various urinary tract infection (UTI) pathogens from patients of different gender and age groups of Pakistanis. Method: For these purposes, urine samples of 109 patients were analyzed. Samples were screened on CLED agar. Antimicrobial susceptibility testing was performed by Kirby Bauer's disc diffusion method. Isolated colonies were processed for biochemical characterization and antibiotic sensitivity to ampicillin, amikacin, augmentin, ceftazidime, ceftriaxone, cefuroxime, cotrimoxazole, ciprofloxin, imipenem, meropenem, tazocine, trimethoprim, gentamicin and nitrofuratoin. Result: E.Coli was found to be the most frequent causative agent of UTIs (66%) followed by Enterococci (8.3%), Candida spp. and Pseodomonas spp. (7.3% each), Klebsiella spp. (5.5%) and Enterobacter spp. (2.7%). Proteus. and Morgenella species were found in less than 1% of the cases. E.coli showed variable antimicrobial resistance to different antibiotics as 92%, 86%, 80%, 62%, 47%, 20% and 4% of the isolates were found to be resistant to ampicillin, cotrimoxazole, ciprofloxin, gentamicin, nitrofuratoin and amikacin, respectively. Conclusion: The most effective in vitro agents were found to be amikacin followed by gentamicin (among the parenterals), and ciprofloxin among the orally administratered ones. A higher prevalence of UTIs was observed in the female population and E.coli showed no resistance to nitrofuratoin in age groups of 50 + and 70 + in both genders.
Tropical Journal of Pharmaceutical Research, 2008
Purpose: This paper was mainly aimed to investigate drug resistance of the various urinary tract infection (UTI) pathogens from patients of different gender and age groups of Pakistanis. Method: For these purposes, urine samples of 109 patients were analyzed. Samples were screened on CLED agar. Antimicrobial susceptibility testing was performed by Kirby Bauer's disc diffusion method. Isolated colonies were processed for biochemical characterization and antibiotic sensitivity to ampicillin, amikacin, augmentin, ceftazidime, ceftriaxone, cefuroxime, cotrimoxazole, ciprofloxin, imipenem, meropenem, tazocine, trimethoprim, gentamicin and nitrofuratoin. Result: E.Coli was found to be the most frequent causative agent of UTIs (66%) followed by Enterococci (8.3%), Candida spp. and Pseodomonas spp. (7.3% each), Klebsiella spp. (5.5%) and Enterobacter spp. (2.7%). Proteus. and Morgenella species were found in less than 1% of the cases. E.coli showed variable antimicrobial resistance to different antibiotics as 92%, 86%, 80%, 62%, 47%, 20% and 4% of the isolates were found to be resistant to ampicillin, cotrimoxazole, ciprofloxin, gentamicin, nitrofuratoin and amikacin, respectively. Conclusion: The most effective in vitro agents were found to be amikacin followed by gentamicin (among the parenterals), and ciprofloxin among the orally administratered ones. A higher prevalence of UTIs was observed in the female population and E.coli showed no resistance to nitrofuratoin in age groups of 50 + and 70 + in both genders.
2019
Detection of resistance pattern of pathogens to frequently prescribed antibiotics is vital and supportive in improving the quality of empirical treatment. Hence, the aim of this study was to explore the pattern of antibiotic resistance of E. coli isolated from patient with Urinary tract infections (UTIs). In this retrospective and observational study, 366 test reports of antibiotic sensitivity of bacterial isolates were used for data analyses which were collected from 9 districts of Bangladesh between June 2017 and August 2018 from the UTI patients. It was found that Escherichia coli (79.51%) was the most common causative agent in UTIs in both male and female patients. The females (>25 years old) and aged male (> 50 years) were more prone to UTIs than other gorups. Among the 34 tested antibiotics, only 4 antibiotics viz. Meropenem, Netilmicin, Imipenem and Amikacin were highly sensitive to E. coli. But, 25 of tested antibiotics were resistant or intermediate to more than 50% i...
International journal of health sciences
One of the most prevalent infections, urinary tract infection (UTI) can affect anyone from a newborn to an elderly person. The most common cause is a bacteria called uropathogenic Escherichia coli (UPEC). The ability to adhere to host epithelial cells in the urinary system is the most important predictor of pathogenicity, however fimbriae, pili, flagella, and secreted (toxins) virulence factors all play a role in the pathogenicity of UroPathogenic Escherichia coli strains. Effective management of UTIs requires up-to-date information on the antibiotic susceptibility pattern of uropathogens. Thirty midstream urine samples were collected from patients at Al-Ramadi Teaching Hospital's Urology Clinic. Isolates of E. coli (the most prevalent bacteria) from the cultured samples are tested for susceptibility to the most common antibiotics in use today. Thirty (75%) of the total 40 samples were culture positive; the most common organisms found were Escherichia coli (16 (53.3), Citrobacte...
2023
Infections of the Urinary tract are the most common infection affecting the human population of all ages. Escherichia coli is a bacterial agent with greatest recurrent cause of UTIs and cause the majority of infections, with other trace bacterial species accounting for a smaller proportion. These pathogens enter the urinary tract from the intestinal biotope, causing dysbacteriosis. Ninety one UTI samples were collected from patients at Sadr Medical City. The sample collection was done from May to August, 2022. By VITEK2 system all isolates were identified; all isolates were tested for sensitivity to 12 antibiotics. In this study, 75 samples (82.4 %) of the 91 samples (urine) were gram-negative bacterial isolates, 14 samples (15.38 %) were gram-positive bacterial isolates, and 2 samples (2.19%) showed no growth.The results revealed that (100%) of isolates have a high resistance rate to Cloxacillin, Ceftazidime, Penicillin, and Piperacillin, followed by Cefotaxime and Ceftriaxone (74.13%) isolates, Cefixime and Cefoxitin (68.96%) isolates, and Ciprofloxacin and Levofloxacin. In conclusions: Antibiotic resistance is still prevalent among pathogenic bacteria that cause urinary tract infections in pregnant women, which can cause dangerous complications to the fetus and the mother.
Journal of Medical Microbiology and Infectious Diseases, 2018
Introduction: Uropathogenic Escherichia coli (UPEC) is among the primary cause of urinary tract infections (UTIs). This study was conducted to determine the antibiotic resistance pattern of E. coli isolates from UTIs in Kermanshah. Methods: In this study, 180 midstream urine samples were collected from outpatients for five months. Based on differential biochemical tests such as oxidase, Indole, and movement, one hundred E. coli isolates were obtained. In order to determine the antibiotic susceptibility of the E. coli isolates, Kirby-Bauer method on the Müller Hinton Agar (Merck, Germany) was performed according to the CLSI instruction, using nalidixic acid (30 mcg), gentamicin (10 mcg), cefalotin (30 mcg), co-trimoxazole (10 mcg), and co-amoxiclav (20 mcg) disks provided by a commercial company (Padtan Teb, Iran). Results: The mean age of the patients was 43.69 years. Out of 100 E. coli-infected patients, 74 were women with an average age of 42.77 years and 26 men with an average age of 45.88 years. The highest rate of UTI was in women aged 61-70 years and the lowest in men aged 71-80 years. The youngest patient was a one-year-old boy, and the oldest was a 95-year-old woman. The highest resistance was found to cefalotin (82%), and only one sample was resistant to gentamicin (1%). Conclusion: Gentamicin and co-amoxiclav are still effective drugs for the empirical treatment of urinary tract infections in Kermanshah. In contrast, cephalothin and possibly the first-generation cephalosporins are not recommended in this province.