EVALUATION OF ANTIBIOTIC RESISTANCE IN E.COLI STRAINS FROM UTI CLINICAL ISOLATES

ABSTRACT Antibiotic resistance among pathogens causing urinary tract infection (UTI) is increasing at an alarming rate. E.coli is found to be the most prevalent among the common bacterial uropathogens isolated. The present study was undertaken to evaluate current antibiotic resistance pattern among the multi drug resistant strains of Escherichia coli isolated from positive UTI samples. 342 clean catch midstream urine samples were collected and processed using standard methods on Blood agar, Mac-Conkey agar and EMB agar. A total of 138 urine samples were reported positive for E.coli which were further characterized by using Morphological and Biochemical characterization. Antimicrobial susceptibility determined by Kirby Bauer disc diffusion method as per Clinical and Laboratory Standard Institute (CLSI) guideline showed 62 isolates (44%) were multi drug resistant. Out of the 14 clinically prescribed antibiotics tested, high level of resistance was seen to Ciprofloxacin (75%), Gatifloxacin (68%), Ceftazidime (62%), Meropenem (51%) and Imipenem (39%). Nitrofurantoin (20%) showed lowest resistance rate respectively. Due to the high prevalence of drug resistance, regular monitoring of patterns of resistance in different areas is very much necessary. This would prevent the unsuitable consumption of the drugs, helps in implementing judicious measures for control of the infection and also deciding empirical therapies for preventing urinary tract infection. Keywords: Escherichia coli, Antibiotic Drug Resistance, Urinary tract infection REFERENCES Akinyemi. K, S Alabi, N Taiwo, E Omonighehin, Antimicrobial susceptibility pattern and plasmid profile of pathogenic bacteria isolated from subjects with urinary tract infections in Lagos, Nigeria. Nig. Qt J Hosp. Med, (1,) 1997, 7-11. Haider G, Zehra N, Munir AA and Haider A. Risk factors of urinary tract infection in pregnancy. JPMA, 2010; 60(3):213-216. Ronald, A., (2003) “The etiology of urinary tract infection: traditional and emerging pathogens”. Dis Mon 49: 71-82. Karlowsky JA, Jones ME, Thornsberry C, 2. Critchley I, Kelly LJ, Sahm DF. Prevalence of anti microbial resistance among urinary tract pathogens isolated from female outpatients across the US in 1999. Int J Antimicrob Agents 2001; 18: 121-7. Gorbach SL, Bartlett JG, Balcklow NR. Urinary tract. In: Gorbach SL, Bartlett JG, Balcklow NR, editors. Infectious diseases. Philadelphia: Lippincott Williams & Wilkins Publishers; 2004. p. 861-81. Memon, B.A., 2007. Predominant and common cause of urinary tract infections in Sukkur city. Rawal med. J., 32:99-101. Gupta, K., Hooton, T.M. and Stamm, W.E., 2001. Increasing antimicrobial resistance and the management of uncomplicated community-acquired urinary tract infections. Ann. Intern. Med., 135:41-50. Livermore D.M., Bacterial resistance: Origins, epidemiology and impact, Clin. Infect. Dis. 36 (2003) 11–23. Davies. J, Inactivation of antibiotics and the dissemination of resistance genes, Science, 264 (1994) 375–382. Tenover F.C, Development and spread of bacterial resistance to antimicrobial agents: An overview, Clin. Infect. Dis. (Suppl.), 33 (2001) 108–115. Aibinu I E, Ohaegbulam V C, Adenipekun, E, Ogunsola, F. T, Odugbemi, T.O, Mee, B.J, Extended-spectrum Beta-Lactamase Enzymes in Clinical isolates of Enterobacter Species from Lagos, Nigeria. J Clin Microbiol 2003a; 41(5): 2197-2200. Hassan, S.H, J. Trop. Med. Hyg., 88, 243-248 (1995). Santo E, Salvador MM and Marin JM. Multidrug-Resistant Urinary Tract Isolates of Escherichia coli from Ribeirao Preto, Sao Paulo, Brazil. The Brazilian Journal of Infectious Diseases. 2007; 11:575-578. Guyot, A.; Barrett, S.P.; Threlfall, E.J.; Hampton, M.D.; Cheasty, T. Molecular epidemiology of multi-resistant Escherichia coli. J.Hosp. Infect., 1999, 43, 39-48. Bryan, S Charles, Infectious diseases in primary care (Philadelphia: W.B. Saunders 2002). Gupta K. Addressing antibiotic resistance. Am J Med. 2002; 113 (Suppl 1A):S29–34. Winorkur P.L., D.L. Vanstein, L.J. Hoffman, E.K. Unlentropp, G.V. Doer, Antimicrob. Agents Ch., 45(10), 2716- 2722 (2001). Miranda S., M.G. Davide, J.C. Peter, Microbiology, 150, 1539-1546, (2004). Talan, D. A., K. G. Naber., J. Palou, D. Elkharrat (2004): Extended release ciprofloxacin (cipro XR) for treatment of urinary tract infections. Int. J. Antimicrob. Agents 23, 554-566. Blondeau, J. M. (2004): Current issues in the management of urinary tract infections: extending release ciprofloxacin as a novel treatment options. Drugs 64, 611-628. Flutt, A. C., M. E. Jone, F. J. Schmitz, J. Acar, R. Guptes, J. Verhoef (2000): Antimicrobial susceptibility and frequency of occurrence of clinical blood isolate in Europe from SENTRY antimicrobial surveillance programme 1997 and 1998. Clin. Infect. Dis. 30, 454-460. Sahm, D. F., C. Thornsberry, D. C. Mayfield, M. E. Jones, J. A. Karlowsky (2001): Multidrug resistant urinary tract isolates of Escherichia coli prevalence and patient dermographic in United States in 2000. Antimicrob. Agents Chemother. 45, 1402-1406. Goettsch, W., W. Van Pelt, N. Nagelkerke, M. G. Hendrix, A. G. Buiting, P. L. Petit (2000): Increasing resistance to fluoroquinolones in Escherichia coli from urinary tract infections in the Netherlands. JAntimicrob. Chemother. 46, 223-228. Garau, T., M. Xercavins, M. Rodriguez-Carhalleira, J. R. Gomez-Vera, I. Coll, D. Vidal (1999): Emergence and dissemination of quinolone resistant Escherichia coli in the community. Antimicrob. Agents Chemother. 43, 2736-2741. Komp, L. P., A. Karlsson, D. Hughes (2003): Mutation rate and evolution of fluoroquinolone resistance in Escherichia coli isolates from patient with urinary tract infections. Antimicrob. Agents Chemother. 47, 3222-3232. Van Belkum, A., W. Goessens, C. Vander Schee, N. Lemmens-Dens Toom, M. C. Vos, J. CORNELISSEN (2001): Emergence of ciprofloxacin resistant enterobacteriaea containing multiple gentamycin resistant associated integrons in a Dutch hospital. Emerg. Infect. Dis. 7, 862-871. Hughes M, Datta N. Conjugative plasmid in bacteria of the pre-antibiotic era. Nature. 1983; 302:725-726. D Byarugaba, A view on antimicrobial resistance in developing countries and responsible risk factors, .Int. J Ant Agents, 24, 2004, 105–10. Overdevest I, Willemsen I, Rijnsburger M, Eustace A, Xu L, Hawkey P, Heck M, Savelkoul P, Vandenbroucke- Grauls C, van der Zwaluw K, Huijsdens X and Kluytmans J. Extended Spectrum - Lactamase genes of Escherichia coli in chicken meat and humans, the Netherlands. Emer Infect Dis, 2011; 17(7): 1216-1222. Cohen M.L., Epidemology of Drug Reisistance: Implications for a post Antimicrobial Era. Science 1992; 257: 1050-1055. Yuksel S, Ozturk B, Kavaz A, et al. Antibiotic resistance of urinary tract pathogens and evaluation of empirical treatment in Turkish children with urinary tract infection. Int J Antimicrob Agent 2006; 28(5): 413-6. Kothari A, Sagar V. Antibiotic resistance in pathogens causing. Community- acquired urinary tract infections in India: a multicenter study. J Infect Dev Ctries 2008; 2: 354-8