Urinary tract infections are the most common bacterial infections globally, caused by Escherichia coli. Escherichia coli produces an enzyme called extended spectrum β-lactamases (ESBL) which inhibits penicillins, cephalosporins and various other antibiotics. The current study included 1720 specimens, isolated from urine samples of inpatients and outpatients suffering from Urinary tract infections. The antimicrobial susceptibility by disc diffusion was performed on each isolate by using 10 antibiotics according to Clinical Laboratory Standards Institute (CLSI) criteria. 370 (21.5%) specimens were confirmed to be E.coli isolates. E.coli isolates were found to be 97.2% sensitive against Imipenem, 96.4% against Meropenem, 50.0% against Gentamicin, 47.2% against Kanamycin, 38.3% against Ciprofloxacin, 15.6% against Doxycycline, and 25.6% sensitive against Co-trimoxazole. A large proportion of E.coli isolates were found to be multi drug resistant. E.coli isolates were found to be 91.8% resistant against Ampicillin, 84.3% against Doxycycline, 82.4% against Cefaclor, and 80.5% resistant against Nalidixic Acid.
Table of Contents
1. Introduction
2. Material and methods
2.1 Bacterial isolates
2.2 Antimicrobial susceptibility testing
2.3 Statistical analysis
3. Results
4. Discussion
Research Objectives and Key Topics
The primary objective of this study is to determine the prevalence of Escherichia coli in urinary tract infections and to evaluate its antimicrobial susceptibility patterns, aiming to improve the management of these infections in Mansehra, Pakistan.
- Isolation and identification of Escherichia coli from clinical urine samples.
- Evaluation of antimicrobial susceptibility using ten common antibiotics.
- Analysis of multi-drug resistance trends in local clinical isolates.
- Comparison of local resistance data with international findings.
- Development of recommendations for empirical antibiotic therapy in the region.
Excerpt from the Publication
Material and methods
In this study, E.coli isolates were collected from public and private hospitals and healthcare centers from June 2009 to March 2010. Only one sample was obtained from each patient and included in the study. Clean catch midstream urine specimens were collected in sterilized bottles and submitted to clinical microbiology laboratory. The samples received were inoculated onto Blood agar and McConkey agar, and then incubated in aerobic atmosphere at 37ᵒC for 24 hours. E.coli isolates were confirmed by biochemical tests. The plates yielding growth as per Kass counts (single specie count more than 105 organisms/ml) were processed further (Kass, 1956).
Antimicrobial susceptibility testing was performed by the modified Kirby Bauer disc diffusion method on Muller-Hinton agar (Oxoid, England) as described by the Clinical Laboratory Standard Institute (CLSI) (CLSI, 2006).
Chapter Summaries
Introduction: Provides the clinical context of E. coli as a primary pathogen in urinary tract infections and discusses the global rise in antimicrobial resistance as a significant therapeutic challenge.
Material and methods: Details the systematic collection of urine samples, the microbiological isolation process using standardized culture media, and the implementation of the Kirby Bauer disc diffusion method for susceptibility testing.
Results: Presents the primary data on isolation rates and the susceptibility percentages of E. coli against ten distinct antimicrobial agents, noting significant resistance trends.
Discussion: Interprets the study findings in the context of previous regional and international research, emphasizing the need for strict antibiotic policies to address high resistance rates.
Keywords
Antimicrobial resistance, Escherichia coli, Extended Spectrum β-Lactamase, Urinary Tract Infections, bacterial isolates, susceptibility testing, Kirby Bauer method, antibiotic therapy, multi-drug resistance, clinical microbiology, empirical treatment, pathogen surveillance.
Frequently Asked Questions
What is the primary focus of this study?
The study focuses on determining the proportions of Escherichia coli in patients with urinary tract infections in Mansehra, Pakistan, and analyzing the antimicrobial susceptibility patterns of these isolates.
What are the main thematic areas covered?
The research covers the isolation of bacteria from clinical specimens, the assessment of resistance profiles against common antibiotics, and the comparative analysis of these profiles with existing global data.
What is the central research question?
The central question is how prevalent E. coli is in local urinary tract infections and to what extent these pathogens remain susceptible or resistant to commonly prescribed antibiotics, thereby guiding efficient clinical management.
Which scientific methodology was employed?
The study used clinical urine samples processed through standard microbiological laboratory techniques, including inoculation on selective media and the modified Kirby Bauer disc diffusion method for susceptibility testing.
What does the main body of the paper address?
It addresses the collection of bacterial isolates, detailed susceptibility results for ten antibiotics, and a discussion on why resistance levels vary and what implications this has for empirical treatment choices.
Which keywords characterize this paper?
Key terms include antimicrobial resistance, Escherichia coli, ESBL, urinary tract infections, and antibiotic susceptibility profiles.
Why is Co-trimoxazole no longer recommended for empiric treatment in Pakistan based on this study?
The study found a very high antimicrobial resistance (72.9%) to Co-trimoxazole among E. coli isolates, rendering it ineffective as a primary empirical choice in this specific region.
What role do Carbapenems play according to the findings?
Carbapenems, such as Imipenem and Meropenem, showed the highest effectiveness against the isolated E. coli, suggesting they are the preferred therapeutic agents for these infections.
How did the patient demographics influence the findings?
The study noted a 3:1 female-to-male ratio in isolates and identified middle-aged patients (20-43 years) as the group with the highest number of infections (54.3%).
- Arbeit zitieren
- Islam Ud Din Khan (Autor:in), 2013, Antimicrobial susceptibility patterns and proportions of Escherichia coli in urinary tract infections in Mansehra, Pakistan, München, GRIN Verlag, https://www.grin.com/document/265002
