Browsing by Subject "ESBL"
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Item Bacteriology of Urinary Tract Infection Among the Patients Visiting Tribhuvan University Teaching Hospital (TUTH)(Department of Microbiology, 2013) Ghimire, SangitaUrinary Tract Infection (UTI) is one of the most common diseases encountered worldwide and is a major public health problem in terms of morbidity and financial costs. A prospective cross-sectional study was carried out from Aug 2012 to Jan 2013 in department of microbiology at TUTH. A total of 1,063 urinary tract samples (Mid stream urine, catheter, and suprapubic aspirate) from patients visiting TUTH were included. Samples were processed for routine microscopy and culture and the organisms were identified by standard microbiological methods. Antibiotic susceptibility testing was done by Kirby-Bauer Disk Diffusion method according to CLSI guidelines. ESBL producing organisms were detected by Combination Disk method, MBL producing organisms were detected by EDTA-Imipenem combined disk assay and Methicillin resistance Staphylococcus aureus (MRSA) was detected by Cefoxitin disk. Of the total 1,063 samples processed, 276(26.0%) samples showed significant bacteriuria. Twelve different genera of bacteria were isolated from total 276 isolates among which E.coli (57.6%) was the most common isolate followed by Staphylococcus aureus (14.1%), Klebsiella spp (6.2%), Enterococcus faecalis (5.4%), Staphylococcus epidermidis (3.9%), Pseudomonas aeruginosa (3.3%), Acinetobacter spp (2.5%), Enterobacter spp (2.2%), Burkholderia cepacia Complex (1.8%), Staphylococcus saprophyticus (1.4%), Citrobacter spp (1.1%) and others (<1%). Among the gram negative isolates (210), majority (61.0%) of the isolates were found MDR. Nearly 58% of MDR isolates were ESBL producer and 5% were MBL producers. Most of the ESBL and MBL producing isolates were detected in E.coli and Klebsiella spp respectively. Most of the Gram negative bacterial isolates were sensitive to Polymyxin B followed by Imipenem, Amikacin and Cotrimoxazole. Among the gram positive isolates (66), 42.4% of isolates were MDR. All the MDR S. aureus (21/39) isolates were found MRSA. All Gram positive isolates were sensitive to Vancomycin and Teicoplanin followed by Amikacin. Among the oral antibiotics tested, Nitrofurantoin was found to be the most sensitive antibiotic for gram positive as well as gram negative bacterial isolates. It revealed that E. coli is the predominant Uropathogens in TUTH, Nepal. There is an increasing resistance to many antibiotics in the both community and hospital settings. Now-a- days, ESBL and MBL producing uropathogens are emerging. Keywords: Antimicrobial Susceptibility Profile, ESBL, MBL, MDR, MRSA, UTIItem Correlation of Multidrug Resistant and Plasmid Profile in ESBL Producing Escherichiacoli In UTI Patients(Department of Microbiology, 2014) Singh, Vivek KumarUrinary Tract Infection (UTI) is one of the most common infectious disease ranking next to upper respiratory tract infection, is the cause of morbidity and mortality in human. Therefore, studying bacterial pathogens causing UTI and their drug susceptibility patterns is of the highest priority. Infections caused by Escherichia coli have become a significant worldwide public health problem.Furthermore, the situation is worsening due to advent of increased antibiotic resistance due to the evolution of multi-resistant antibiotic plasmid genes.Extended Spectrum Beta lactmases (ESBLs) are plasmid mediated and the seen zyme producing organisms exhibit co resistance to many other classes of antibiotics. A total of 1258 urine samples were collected from May2013 to November 2013.Bacterial isolates were identified using standard biochemical tests and antimicrobial susceptibility pattern was determined using the Kirby–Bauer’s disk diffusion method following CLSI guidelines. Confirmation of the extended spectrum β-lactamase (ESBL) E.coli was done as guided by CLSI guidelines.Plasmid DNA isolation of all the ESBL positive strains was done by alkalinelysis method. Inthe present study, out of 303isolates, 198isolates were ofE.coli. These isolates were tested for antibiotic sensitivity, MDR, ESBL and plasmid profiles. The results revealed that more than 50% of the isolates exhibited multi-drug resistance. Out of 76ESBL E.coli isolates, 41(53.9%) were found to possess plasmids. Some isolates possess single plasmid while other had multiple plasmids with different size ranged from 1 kb to 10kb.The studies show good prospects for further research in the same area to explore and assign definite cause for antibiotic resistance, multi drug resistance and ESBL production. Keywords: Prevalence; Urinary tract infection; Antimicrobial susceptibility pattern;MDR;ESBL; Plasmid Profile.Item Urinary Tract Infection in Pregnant Women and Antibiotic Susceptibility Pattern of Bacterial Isolates with Reference to Extended Spectrum Beta Lactamase Producing Strains(Department of Microbiology, 2011) Thapa, RekhaThe objective of this study was to determine the prevalence of urinary tract infection among the pregnant women and antibiotic susceptibility pattern of bacterial isolates with reference to extended spectrum β-lactamase producing strains. This cross sectional study was conducted at Paropakar Maternity and Women’s Hospital,Thapathali, Kathmandu from June to December 2010 among 1720 pregnant women attending their antenatal checkup. Information regarding various characteristics was obtained and urinespecimen was processed for isolation of bacteria, performing antibiotic susceptibility test byKirby-bauer disc diffusion method and ESBL test by Double Disc Synergy Test (DDST) method. The prevalence of UTI was found to be 30.5%. Majority of the pregnant women were fromoutpatient department of hospital (65.7%), urban areas of the country (52.3%), age group 21-30years (74.3%), unemployed (73.3%), literate (88.0%), primiparous (54.3%) and second trimesterof pregnancy (48.3%). Parity, education status, occupation of pregnant women, times of bathing,history of UTI, presence of pus cells and RBC in urine was found to be the risk factors of UTIfrom both univariate and multivariate analysis. E. coli (52.0%) was found to be the mostpredominant isolate and Pseudomonas aeruginosa (0.7%) was least one. Gentamicin andamikacin were found to be the most effective antibiotics. About 72.0% of the isolates were foundto be multidrug resistant with higher rate in hospitalized patients (84.0%). About 20.0% ofE.coli and 36.4% of the Klebsiella pneumoniae were found to be the ESBL producers. There is a great need to follow strictly the hospital antimicrobial policy in order to prevent the emergence and dissemination of MDR and ESBL producing microorganisms as they are associated with the treatment failure of UTI. KEY WORDS: Pregnant women, UTI, multi drug resistant, ESBL