Etiology and antibiotic resistance patterns of community-acquired urinary tract infections in J N M C Hospital Aligarh, India

被引:249
作者
Akram M. [1 ]
Shahid M. [2 ]
Khan A.U. [1 ]
机构
[1] Interdisciplinary Biotechnology Unit, Aligarh Muslim University
[2] Microbiology Department, JN Medical College and Hospital, AMU, Aligarh
关键词
Urinary Tract Infection; Amikacin; Imipenem; Generation Cephalosporin; Cefpodoxime;
D O I
10.1186/1476-0711-6-4
中图分类号
学科分类号
摘要
Background: Urinary tract infections (UTIs) remain the common infections diagnosed in outpatients as well as hospitalized patients. Current knowledge on antimicrobial susceptibility pattern is essential for appropriate therapy. Extended-Spectrum beta-Lactamase (ESBL) producing bacteria may not be detected by routine disk diffusion susceptibility test, leading to inappropriate use of antibiotics and treatment failure. The aim of this study was to determine the distribution and antibiotic susceptibility patterns of bacterial strains isolated from patients with community acquired urinary tract infections (UTIs) at Aligarh hospital in India as well as identification of ESBL producers in the population of different uropathogens. Methods: Urinary isolates from symptomatic UTI cases attending to the JN Medical College and hospital at Aligarh were identified by conventional methods. Antimicrobial susceptibility testing was performed by Kirby Bauer's disc diffusion method. Isolates resistant to third generation cephalosporin were tested for ESBL production by double disk synergy test method. Results: Of the 920 tested sample 100 samples showed growth of pathogens among which the most prevalent were E. coli (61%) followed by Klebsiella spp (22%). The majority (66.66%) of the isolates were from female while the remaining were from male. Among the gram-negative enteric bacilli high prevalence of resistance was observed against ampicillin and co-trimoxazole. Most of the isolates were resistant to 4 or more number of antibiotics. Forty two percent of isolates were detected to produce ESBL among which 34.42 % were E. coli isolates. Conclusion: This study revealed that E. coli was the predominant bacterial pathogen of community acquired UTIs in Aligarh, India. It also demonstrated an increasing resistance to Co-trimoxazole and production of extended spectrum β-lactamase among UTI pathogens in the community. This study is useful for clinician in order to improve the empiric treatment. © 2007 Akram et al; licensee BioMed Central Ltd.
引用
收藏
相关论文
共 38 条
[1]  
Gonzalez C.M., Schaeffer A.J., Treatment of urinary tract infection: What's old, what's new, and what works, World J Urol, 6, pp. 372-382, (1999)
[2]  
Sobel J.D., Kaye D., Urinary tract infections, Mandell, Douglas and Bennett's. Principals and Practice of Infectious Diseases, (2000)
[3]  
Schaeffer A.J., The expanding role of fluoroquinolones, Am J Med, 113, SUPPL. 1A, (2002)
[4]  
Biswas D., Gupta P., Prasad R., Singh V., Arya M., Kumar A., Choice of antibiotic for empirical therapy of acute cystitis in a setting of high antimicrobial resistance, Indian J Med Sci, 60, 2, pp. 53-58, (2006)
[5]  
Goldstein F.W., Antibiotic susceptibility of bacterial strains isolated from patients with community-acquired urinary tract infections in France. Multicentre Study Group, Eur J Clin Microbiol Infect Dis, 19, pp. 112-117, (2000)
[6]  
Gupta V., Yadav A., Joshi R.M., Antibiotic resistance pattern in uropathogen, Indian J Med Microbiol, 20, pp. 96-98, (2002)
[7]  
Tankhiwale S.S., Jalgaonkar S.V., Ahamad S., Hassani U., Evaluation of extended spectrum beta lactamase in urinary isolates, Indian J Med Res, 120, pp. 553-556, (2004)
[8]  
Kumar M.S., Lakshmi V., Rajagopalan R., Related Articles, Occurrence of extended spectrum beta-lactamases among Enterobacteriaceae spp. isolated at a tertiary care institute, Indian J Med Microbiol, 24, pp. 208-211, (2006)
[9]  
Manges A.R., Natarajan P., Solberg O.D., Dietrich P.S., Riley L.W., The changing prevalence of drug-resistant Escherichia coli clonal groups in a community: Evidence for community outbreaks of urinary tract infections, Epidemiol Infect, 134, 2, pp. 425-431, (2006)
[10]  
Kahan N.R., Chinitz D.P., Waitman D.A., Dushnitzky D., Kahan E., Shapiro M., Empiric treatment of uncomplicated urinary tract infection with fluoroquinolones in older women in Israel: Another lost treatment option?, Ann Pharmacother, 40, 12, pp. 2223-2227, (2006)