American Journal of Microbiological Research
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American Journal of Microbiological Research. 2016, 4(4), 122-125
DOI: 10.12691/ajmr-4-4-3
Open AccessArticle

Antimicrobial Sensitivity Pattern of Escherichia coli Causing Urinary Tract Infection in Bangladeshi Patients

Nayareen Akhtar1, , Rezwanur Rahman2 and Shahin Sultana1

1Department of Microbiology, Delta Medical College

2Department of Nephrology, Bangladesh Medical College & Hospital

Pub. Date: July 19, 2016

Cite this paper:
Nayareen Akhtar, Rezwanur Rahman and Shahin Sultana. Antimicrobial Sensitivity Pattern of Escherichia coli Causing Urinary Tract Infection in Bangladeshi Patients. American Journal of Microbiological Research. 2016; 4(4):122-125. doi: 10.12691/ajmr-4-4-3

Abstract

Objectives: Urinary tract infection (UTI) is a common bacterial infection in the Bangladesh community. There has been an increasing resistance by Escherichia coli to the commonly available antibiotics. The aim of the present study was to determine the prevalence of UTI, the common causative bacteria & antimicrobial susceptibility patterns of E. coli responsible for urinary tract infections (UTIs) to currently used antimicrobial agents. Methods and Results: In this study, three hundred urine specimens from clinically suspected UTI patients were collected from both outpatient and inpatient department during the period of February 2015 to January 2016 from a tertiary level hospital in the central part of country. The inclusion criteria included patients presenting with symptoms suggestive of UTI at the study site and who gave informed written consent to participate in the study. The exclusion criteria included patients on antibiotics within the last 2 weeks, and those with recent history of instrumentation. The urine samples received were processed using standard methods. Antimicrobial sensitivity patterns were performed on all E. coli isolates obtained from urine samples by disc diffusion method. Among 300 urine samples, (59%) yielded significant bacteriuria; 123 samples (41%) showed no growth. Out of 177 urine samples which showed significant bacterial growth, 72 (40.7%) samples comprised of males and 105 (59.3%) of females. Females within the age group of 20–29 years(26.67%) and elderly males of ≥60 years(34.7%) showed higher prevalence of UTI. 75.7% of isolates were found to be Escherichia coli, 7.9% Klebsiella pneumoniae, 5.6% Proteus mirabilis, Pseudomonas aeruginosa 5.1%, 1.7% Enterococci faecalis, 2.8% Staphylococci saprophyticus and 1.1% were Staphylococcus aureus. E. coli as the predominant cause of UTI, showed the highest percentage of resistance to co-trimoxazole, nalidixic acid and amoxicillin. The isolates were most sensitive to Imipenam, Meropenam, Nitrofurantoin and Amikacin. Klebsiella pneumoniae was the second most prevalent pathogen. Conclusion: E. coli was the most frequent isolate. Imipenam, Meropenam, Nitrofurantoin and Amikacin were shown to be very effective against E. coli organisms.

Keywords:
Urinary Tract Infections Causative agents Escherichia coli Antimicrobial resistance

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References:

[1]  Levi ME, Redington J, Barth L. The Patient With Urinary Tract Infection. Manual of Nephrology 6th Edition. Lippincott Williams & Wilkins. 2005; 7: 91.
 
[2]  Delanghe J, Kouri TT, Huber AR, Hannemann-Pohl K, Guder WG, Lun A, et al. The role of automated urine particle flow cytometry in clinical practice. Clin Chim Acta 2000; 301: 1-18.
 
[3]  Johnson EK, Wolf JS. Urinary Tract Infections in Pregnancy. [Accessed October 12, 2013]; Medscape. Available from: http://emedicine.medscape.com/article/452604-overview.
 
[4]  Patterson TF, Andriole VT. Bacteriuria in pregnancy. Infect Dis Clin North Am. 1987;1(4):807-822.
 
[5]  Schieve LA, Handler A, Hershow R, Persky V, Daris F. Urinary tract infection during pregnancy: its association with maternal morbidity and perinatal outcome. Am J Public Health. 1994; 84(3): 405-410.
 
[6]  Gupta KAD, Hooton CL, Wobe, Stamm WE, 1999. The prevalence of antimicrobial resistance among uropathogens causing uncomplicated cystitisin young women. International Journal ofAntimicrobial agents 11: 305-308.
 
[7]  Nicole W, Jon DM. Deciphering Dysuria. Emerg Med. 2008; 40(9): 29.
 
[8]  Pezzlo M. Detection of urinary tract infection by rapid methods. Clin Microbiol Rev 1988;3:268-80.
 
[9]  Bonadio M, Meini M, Spetaleri P, Gilgi C. Current microbiological and clinical aspects of urinary tract infections. Eur J Urol 2001;40:439-45.
 
[10]  Cunningham FG, Gant NF, Leveno KJ, Gilstrap LC, III, Hauth JC, Wenstrom KD. Renal and Urinary Tract Disorders. In: Andrea Seils, Noujaim SR, Daris K., editors. Williams Obstetrics. 21st ed. New York: McGraw-Hill Medical Publishing Divsion; 2001. pp. 1251-1272.
 
[11]  Arias F. Abnormalities of the urinary system during pregnancy. In: Daftary SN, Bhide AG, editors.Practical Guide to High Risk Pregnancy and Delivery. A South Asian Perspective. 3rd ed. New Delhi: Elsevier; 2008. pp. 489-505.
 
[12]  Blondeau JM. Current issues in the management of urinary tract infections: extended-release ciprofloxacin as a novel treatment option. Drugs. 2004; 64(6): 611-28.
 
[13]  National Committee for Clinical Laboratory Standards. Performance standards for antimicrobial disc susceptibility tests. 7th ed. Wayne, Pennsylvania, USA: NCCLS; 2000. M2-A7.
 
[14]  Abdul IF, Onile BA. Bacterial isolates from urine of women in Ilorin and their antibiotic susceptibility patterns. Trop J Obstet Gynaecol. 2001;18(2):61-65.
 
[15]  Arias F. Abnormalities of the urinary system during pregnancy. In: Daftary SN, Bhide AG, editors.Practical Guide to High Risk Pregnancy and Delivery. A South Asian Perspective. 3rd ed. New Delhi: Elsevier; 2008. pp. 489–505.
 
[16]  Goldstein FW. 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. 2000; 19:112-7.
 
[17]  Ezechi OC, Fasubaa OB, Dare FO. Antibiotic sensitivity patterns of microbial Isolates from urine of pregnant women with urinary tract infections. Trop J Obstet Gynaecol. 2003;20(2):113-115.
 
[18]  Ashkenazi S, EvenTov S, Samra Z, et al. Uropathogens of various childhood populations and their antibiotic susceptibility. Pediatr Infect Dis J. 1991; 10: 742-6.
 
[19]  Grude N, Tveten Y, Kristiansen BE. Urinary tract infections in Norway: bacterial etiology and susceptibility, a retrospective study of clinical isolates. Clin Microbiol Infect 2001;7:543-7.
 
[20]  Kripke C. Duration of therapy for women with uncomplicated UTI. Am Fam Physician 2005;72:2219.
 
[21]  Daniel F. Sahm, Clyde Thornsberry, David C. Mayfield,Mark E. Jones, James A. Karlowsky, 2001.Multidrug-Resistant Urinary Tract Isolates of Escherichia coli: Prevalence and Patient Demographics in the United States. Journal of Antimicrobial Agents Chemotherapy Vol. 45;5: 1402-1406.
 
[22]  Nicolle LE, 2001. Epidemiology of urinary tract infection, Journal of Infection Medicine,18:153-162.
 
[23]  J. G. Collee, R. S. Miles, and B. Watt, “Tests for the identification of bacteria,” in Mackie and Mc Artney Practical Medical Microbiology, J. G. Collee, A. G. Fraser, B. P. Marmion, and A. Simmons, Eds., p. 433, Churchill Livingstone, London, UK, 1996.
 
[24]  V. Rajalakshmi and V. Amsaveni, “Antibiotic susceptibility of bacterial pathogens isolated from diabetic patients,” International Journal of Microbiological Research, vol. 3, no. 1, pp. 30-32, 2012.
 
[25]  S. Sood and R. Gupta.Antibiotic resistance pattern of community acquired uropathogens at a tertiary care hospital in Jaipur, Rajasthan. Indian Journal of Community Medicine. 2012. 37(1): 39-44.
 
[26]  O. A. Aiyegoro, O. O. Igbinosa, I. N. Ogunmwonyi, E. Odjadjaro, O. E. Igbinosa, and A. I. Okoh, “Incidence of urinary tract infections (UTI) among children and adolescents in Ile-Ife, Nigeria,” African Journal of Microbiological Research, vol. 1, pp. 13-19, 2007.
 
[27]  K. C. Arul, K. G. Prakasam, D. Kumar, and M. Vijayan, “A cross sectional study on distribution of urinary tract infection and their antibiotic utilization pattern in Kerala,” International Journal of Research in Pharmaceutical and Biomedical Sciences, vol. 3, no. 3, pp. 1125-1130, 2012.
 
[28]  B. A. M. Adedeji and O. A. Abdulkadir. Etiology and antimicrobial resistance pattern of bacterial agents of urinary tract infections in students of tertiary institution in Yola metropolis. Advances in Biological Researchno. 2009.3. (4): 67-70.
 
[29]  I. Shaifali, U. Gupta, S. E. Mahmood, and J. Ahmed. Antibiotic susceptibility patterns of urinary pathogens in female outpatients. North American Journal of Medical Sciences. 2012. 4(4): 163-169.
 
[30]  T. M. Hooton, D. Scholes, J. P. Hughes et al.A prospective study of risk factors for symptomatic urinary tract infection in young women. The New England Journal of Medicine.1996. 335. (7): 468-474.
 
[31]  Jawetz, E. and Melnick, 1995. Clinical correlations: urinary tract in Medical Microbiology, 20th Ed. London, UK, PrenticeHall Intl Inc. p. 634.
 
[32]  S. Shankel, Urinary Tract Infections Genitourinary Disorders, The Merck Manuals Online Medical Library, 2007.
 
[33]  K. Shigemura, K. Tanaka, H. Okada et al., “Pathogen occurrence and antimicrobial susceptibility of urinary tract infection cases during a 20-year period (1983-2002) at a single institution in Japan,”Japanese Journal of Infectious Diseases, vol. 58, no. 5, pp. 303-308, 2005.
 
[34]  M. Dash, S. Padhi, I. Mohanty, P. Panda, and B. Parida, “Antimicrobial resistance in pathogens causing urinary tract infections in a rural community of Odisha, India,” Journal of Family and Community Medicine, vol. 20, no. 1, pp. 20-26, 2013.
 
[35]  O. Omigie, L. Okoror, P. Umolu, and G. Ikuuh, “Increasing resistance to quinolones: a four-year prospective study of urinary tract infection pathogens,” International Journal of General Medicine, vol. 2, pp. 171-175, 2009.
 
[36]  E. M. Abubakar, “Antimicrobial susceptibility pattern of pathogenic bacteria causing urinary tract infections at the Specialist Hospital, Yola, Adamawa State, Nigeria,” Journal of Clinical Medicine Research, vol. 1, no. 1, pp. 001-008, 2009.
 
[37]  Johnson JR.Virulence factors in Escherichia coli urinary tract infection.Clin Microbiol Rev.1991;4(1):80-128.
 
[38]  M. Sharifian, A. Karimi, S. R. Tabatabaei, and N. Anvaripour, “Microbial sensitivity pattern in urinary tract infections in children: a single center experience of 1,177 urine cultures, Japanese Journal of Infectious Diseases, vol. 59, no. 6, pp. 380-382, 2006.
 
[39]  E. M. Abubakar, “Antimicrobial susceptibility pattern of pathogenic bacteria causing urinary tract infections at the Specialist Hospital, Yola, Adamawa State, Nigeria,” Journal of Clinical Medicine Research, vol. 1, no. 1, pp. 001-008, 2009.
 
[40]  J. C. Uwaezuoke and N. Ogbulie, “Antibiotic sensitivity pattern of urinary tract pathogens in Port-Harcourt, Nigeria,” Journal of Applied Sciences and Environmental Management, vol. 10, no. 3, pp. 103-107, 2006.
 
[41]  Majumder MI, Ahmed T, Hossain D, Begum SA. Bacteriology and antibiotic sensitivity patterns of urinary tract infections in a tertiary hospital in Bangladesh. Mymensingh Med J. 2014 Jan; 23(1):99-104.
 
[42]  Khotaii Q, Mamishi S, Saligeh RN. Antibiotic resistance of germs isolated from urinary tract infections. Iran J Pediatr 2002;12:28-32.
 
[43]  Garau J, Xercavins M, Rodriguez-Carballeira M, Gomez-Vera JR, Coll I, Vidal D, et al. Emergence and dissemination of quinoloneresistant Escherichia coli in the community. Antimicrob Agents Chemother 1999; 43: 2736-41.
 
[44]  Natsch S, Conrad C, Hartmeier C, Schmid B. Use of amoxicillin-clavulanate and resistance in Escherichia coli over a 4-year period. Infect Control Hosp Epidemiol 1998;19:653-6.
 
[45]  N. Goel, U. Chaudhary, R. Aggarwal, and K. Bala, “Antibiotic sensitivity pattern of gram negative bacilli isolated from the lower respiratory tract of ventilated patients in the intensive care unit,” Indian Journal of Critical Care Medicine, vol. 13, no. 3, pp. 148-151, 2009.
 
[46]  M.-L. Joly-Guillou, M. Kempf, J.-D. Cavallo et al., “Comparative in vitro activity of Meropenem, Imipenem and Piperacillin /tazobactam against 1071 clinical isolates using 2 different methods: a French multicentre study,” BMC Infectious Diseases, vol. 10, article 1471, 2010
 
[47]  A. J. Al-Zahran and N. Akhtar, “Susceptibility patterns of extended spectrum beta-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae isolated in a teaching hospital,” Pakistan Journal of Medical Research, vol. 44, pp. 64-67, 2005.