DRUG RESISTANCE PATTERN IN ESBL PRODUCING E.COLI IN CLINICAL ISOLATES FROM STAND ALONE DIAGNOSTIC CENTRE IN CENTRAL MADHYA PRADESH
Authors: Sodani Sadhna, Hawaldar Ranjana.
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Background: Growing multiple drug resistance in microorganisms is of great importance and so is the knowledge about the current drug susceptibility pattern for deciding the empirical usage of antibiotics. E.coli is one of the commensals in the human intestinal tract and contributes to the maintenance of Health of the person. However when E.coli enters into unnatural sites, it can cause variety of infections, bacteremia, meningitis and other soft tissue infections. The emergence of antibiotic resistance in Ecoli is threatening the effectiveness of many antibiotics which has resulted in increased hospital stay of patients, which in turn causes economic burden. Extended spectrum Beta lactamase (ESBL) producing E.coli has tremendously increased worldwide and it is one of the most common causes of morbidity and mortality associated with hospital acquired infections.
Objective: The present retrospective study highlights the susceptibility pattern of E.coli in clinical specimens obtained at Sampurna Sodani Daignostic Clinic Indore (MP) Microbiology department for the year 2014 from January to July.
Materials and methods: This was a retrospective study of ESBL producing E.coli in different clinical specimens including urine, blood, pus, vaginal swab, stool, semen, aural swab, BAL fluid and conjuctival swab obtained from out patients at Sampurna Sodani Diagnostic Clinic Microbiology department located in Indore (Madhya Pradesh) from January to July 2014 and reported in fully automated Microscan (Siemens) according to CLSI guidelines. A total of 542 samples were reviewed. A total of 29 antibiotics were assessed for the resistance pattern in E.coli isolates.
Results: Out of 542 E.coli isolates grown in the lab from urine, blood, pus, vaginal swab, stool, aural swab, BAL fluid, and conjunctival swab. 420 isolates showed sensitivity to imipenem, amikacin, meropenem, and piperacillin/tazobactum in more than 70 % cases.
Conclusion: ESBLs are enzymes that mediate resistance to extended spectrum Beta lactamase (third generation) cephalosporins (eg. Ceftazidime, cefotaxime, & ceftriaxone) and monobactums (eg. Aztreonam) but do not affect cephamycins (eg.cefoxitin) or carbapenems (eg.meropenem or imipenem). 40. 95% isolates of E.coli were ESBL. Among oral antibiotics highest sensitivity was observed to nitrofurantoin (68.33 %) and Amoxy/ Clavulinic acid (44.8%) which can be the drug of choice for E.coli infections specially in UTI. Injectable drugs like Imipenem (90.4%) and Amikacin showed sensitivity in 84.87% isolates but being injectable drugs, should be used with caution.