Urinary tract infection (UTI) is the commonest bacterial infection worldwide resulting from the invasion and multiplication of bacteria in urinary tract. It is more common in females due to short urethra and close proximity with anal canal. It can be mild like cystitis to severe leading to septicemia and death. Escherichia coli(E. Coli) is the leading organism responsible for UTI. Resistance to antibiotics is on rise particularly in developing countries where no antibiotic policies are made. Multidrug resistant (MDR) strains of E. coli are emerging which has made the use of many antibiotics inappropriate. Determination of MDR strains and their susceptibility to amikacin was determined in this study.
Objectives:
The main objectives were to determine the frequency of MDR strains of E. coli causing UTI and to determine their sensitivity to amikacin.
Material and methods:
Study design: Descriptive cross sectional
Study duration: From 21st August 2015 to 30th June 2016.
Setting: Department of medicine Khyber Teaching Hospital, Peshawar.
Sample size: Sample size was 179.
Results:
Out of 179 patients with positive urine culture for E. coli, infection was more common in females, 116(64.8%) were females, 63(35.2%) were male with a male to female ratio of 1:1.84, high prevalence of drug resistance, MDR strains were isolated from 155(86.6%), which showed a sensitivity of 92.25% to amikacin.
Conclusion:
Drug resistance is on rise with a trend towards prevalence of multidrug resistant strains in the community, cautious and appropriate use of antibiotics is advised.
Table of Contents
INTRODUCTION
LITERATURE REVIEW
URINARY TRACT INFECTION
DIFFERENTIAL DIAGNOSIS OF UTI
COMPLICATIONS OF UTI
PREVENTION OF UTI
E. COLI
ANTIMICROBIAL RESISTANCE
PREVENTION OF ANTIMICROBIAL RESISTANCE
MULTIDRUG RESISTANT E COLI
AMINOGLYCOSIDES
MATERIALS AND METHODS
RESULTS
DISCUSSION
CONCLUSION
Research Objectives and Focus
This study focuses on the prevalence of multidrug-resistant (MDR) strains of Escherichia coli (E. coli) among patients diagnosed with urinary tract infections (UTIs) at the Khyber Teaching Hospital in Peshawar. The primary research goal is to determine the frequency of these MDR strains and evaluate their specific antibiotic susceptibility patterns, with a particular focus on the efficacy of amikacin as a therapeutic option.
- Prevalence analysis of MDR E. coli in clinical UTI isolates.
- Evaluation of antibiotic susceptibility patterns against common uropathogens.
- Assessment of amikacin sensitivity among multidrug-resistant E. coli.
- Analysis of demographic factors (age/gender) associated with MDR strain incidence.
- Documentation of resistance trends to guide empirical antibiotic therapy.
Excerpt from the Book
PATHOGENESIS OF URINARY TRACT INFECTION
The interplay of host, environmental factors and pathogen play role whether a symptomatic infection after invasion of bacteria will occur. Most uropathogens arise from the rectal flora and colonize the bladder via the periurethral area and then urethra. Anything that increases the likelihood of bacteria entering the bladder and staying there increases the chances of UTI. A small percentage of UTI is also caused by bacterial invasion through hematogenous route.
Environmental factors:
Vaginal ecology:In women, vaginal ecology is an important environmental factor affecting the risk of urinary tract infection. Alteration in the vaginalmicrobial flora and colonization of the vagina and periurethral area with organisms from the intestinal flora (usually E. coli) is the initial step in the pathogenesis of UTI. Sexual intercourse is associated with an increased risk of vaginal colonization with E. coliand thereby increases the risk of UTI. Spermicide is toxic to the normal vaginal microflora and thus is associated with an increased risk of E. colivaginal colonization and bacteriuria.
In postmenopausal women, the previously predominant vaginal lactobacilli are replaced with colonizing gram-negative bacteria.
Summary of Chapters
INTRODUCTION: Provides an overview of the global burden of UTIs, the role of E. coli as the leading pathogen, and the clinical challenges posed by emerging antibiotic resistance.
LITERATURE REVIEW: Discusses the definitions, epidemiology, risk factors, and pathogenesis of UTIs, including anatomical and host-specific factors influencing susceptibility.
DIFFERENTIAL DIAGNOSIS OF UTI: Examines clinical conditions that mimic UTI, such as prostatitis and urethritis, and outlines the diagnostic significance of sterile pyuria.
COMPLICATIONS OF UTI: Covers severe manifestations like emphysematous pyelonephritis and abscesses, as well as the surgical management of calculi-related infections.
PREVENTION OF UTI: Offers practical guidelines for hygiene, behavioral adjustments, and medical interventions to prevent recurrent urinary tract infections.
E. COLI: Details the biological characteristics of E. coli and the mechanisms by which uropathogenic strains (UPEC) invade the urinary tract.
ANTIMICROBIAL RESISTANCE: Analyzes the mechanisms of acquired resistance and the socio-economic factors, such as antibiotic misuse and quackery, driving resistance in developing nations.
PREVENTION OF ANTIMICROBIAL RESISTANCE: Discusses the importance of antimicrobial stewardship programs (ASPs), appropriate prescribing practices, and hygiene in clinical settings.
MULTIDRUG RESISTANT E COLI: Focuses on the burden and prevalence of MDR E. coli, identifying specific risk factors and potential management strategies.
AMINOGLYCOSIDES: Evaluates the pharmacological profile of aminoglycosides, with a specific focus on the mechanism of action, side effects, and clinical utility of amikacin.
MATERIALS AND METHODS: Describes the descriptive cross-sectional study design, sampling techniques, and laboratory procedures used at Khyber Teaching Hospital.
RESULTS: Presents the findings regarding patient demographics and the specific sensitivity/resistance rates of the isolated E. coli strains.
DISCUSSION: Interprets the findings in the context of existing literature and discusses the clinical implications for empirical therapy.
CONCLUSION: Summarizes the study findings, emphasizing the necessity of judicious antibiotic use and the role of amikacin in hospital settings.
Keywords
Urinary tract infection, E. coli, antibiotic resistance, multidrug resistance, MDR, amikacin, antibiotic sensitivity, uropathogens, empirical therapy, clinical microbiology, hospital-acquired infection, antimicrobial stewardship, cystitis, pyelonephritis, antibiotic susceptibility.
Frequently Asked Questions
What is the core subject of this research?
The research investigates the prevalence of multidrug-resistant (MDR) E. coli in patients with urinary tract infections and determines the sensitivity of these resistant strains to the antibiotic amikacin.
What are the central themes discussed in the paper?
The central themes include the rising global problem of antimicrobial resistance, the pathophysiology of UTI, specific risk factors for infection, and the clinical management of resistant bacterial strains.
What is the primary research goal?
The primary goal is to find the local burden of MDR E. coli causing UTI and to establish whether amikacin remains a reliable empirical treatment option given the current landscape of antibiotic resistance.
Which scientific methodology was employed?
A descriptive cross-sectional study was conducted, involving the collection and culture of urine samples from 179 patients, followed by susceptibility testing using minimum inhibitory concentration methods.
What topics are covered in the main body?
The main body covers the epidemiology and pathogenesis of UTI, common complications, strategies for prevention, the mechanisms of antimicrobial resistance, and the specific pharmacological profile of aminoglycosides.
Which keywords characterize this work?
The work is characterized by terms such as urinary tract infection, E. coli, antimicrobial resistance, MDR, amikacin, antibiotic sensitivity, and antimicrobial stewardship.
How does gender impact UTI prevalence according to this study?
The study found that UTIs are significantly more common in females than in males, which is attributed to anatomical factors such as a shorter urethra and proximity to the anal canal.
Why is amikacin highlighted as a potential treatment?
Amikacin is highlighted because, despite increasing rates of resistance to other antibiotics, the study demonstrates that E. coli strains retain high sensitivity to amikacin, making it a viable empirical choice in hospital settings.
- Citar trabajo
- Muhammad Shabbir (Autor), 2017, Multidrug resistant E. Coli in urinary tract infections. Sensitivity to Amikacin, Múnich, GRIN Verlag, https://www.grin.com/document/384620
