Vijetha Sajjanar

Abstract

Background: Urinary tract infections (UTI) are most common bacterial infections encountered in clinical practice and E.coli is predominant organism causing UTI. Objectives of the study: 1. To study antibiotic resistance pattern among uropathogenic E.coli (UPEC). 2. To study extended spectrum beta lactamase (ESBL) production and their correlation with antibiotic resistance among uropathogenic E.coli (UPEC). 3. To study biofilm formation and its correlation with antibiotic resistance among uropathogenic E.coli (UPEC). Materials and Methods: A prospective study was conducted on first 100 Escherichia coli isolated from urine specimens of patients suspected to be having urinary tract infection between January 2016 and December 2016 received at Department of Microbiology, SIMS Shimoga. Fresh midstream urine samples were aseptically collected in sterile containers and plated on Blood agar & MacConkey agar plates using a standard loop technique & the growth was processed by standard bacteriological technique. Biofilm detection was done by tube and microtitre plate method. ESBL detection was done according to CLSI criteria. Antimicrobial sensitivity testing was done using Kirby-Bauer methods on Mueller-Hinton agar. Results were interpreted as per the CLSI guidelines. Result: Antibiotic sensitivity of E.coli was nitrofurantoin (100%) fosfomycin (100%) imipenem (77%) cotrimoxazole (61%) amikacin (47%) aztreonam (53%) piperacillintazobactam (41%). cefotaxim (25%) ceftazidime (32%) norfloxacin (20%) ampicillin-sulbactam (12%) ciprofloxacin (15%), levofloxacin (12%), amoxiclavulanicacid (15%). ESBL positive were 83% (screening), 80% (confirmatory). Biofilm positive were 63% (tube method) 79% (Microtiterplate method). Conclusion: This study showed Fosfomycin and Nitrofurantoin were the most sensitive drug. Study shows antibiotic resistance was seen more in ESBL and Biofilm producers compared to non ESBL and non biofilm producers. Keywords: Antibiotic resistance, ESBL, Biofilm, UTIUPEC

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Abstract

Background: Pseudomonas aeruginosa causes life threatening infections especially hospital acquired infections or nosocomial infections. Biofilm producing Pseudomonas aeruginosa isolates causes multidrug resistance pattern causing increase morbidity and mortality in a tertiary care hospital. Aim’s and Objectives: 1. Isolation and identification of Pseudomonas aeruginosa; 2. To detect biofilm formation among Pseudomonas aeruginosa isolates; 3. To detect antibiotic resistance pattern among Pseudomonas aeruginosa isolates; 4. To study correlation between biofilm formation and Imipenem resistance among Pseudomonas aeruginosa isolates Materials and Methods: A prospective cross sectional study was conducted on all the clinical samples received from ICU (intensive care unit) at Department of Microbiology, SIMS, Shimoga between January 2018 to December 2018. All the clinical samples were processed, identification and isolation of Pseudomonas aeruginosa, detection of biofilm formation was done as per Standard microbiological methods. Antibiotic susceptibility test was done following Kirby bauer disk diffusion test (DDT) as per CLSI 2017 guidelines. Results: Out of 383 clinical samples received 294(76.76%) were positive cultures and 89(23.23%) were culture negative samples. Klebsiella species 106(36.05%) was most common organisms isolated followed by Staphylococcus aureus 70(23.80%), Pseudomonas spp. 66(22.44%), Escherichia coli 21(7.14%), Gram negative non fermenters (GNNF) 19(6.46%), Coagulase negative Staphylococcus aureus (CoNS) 12(4.08%). Out of 66 Pseudomonas aeruginosa isolates 48(72.72%) were biofilm producers and 18(27.27%) were biofilm non producers. Among 48 biofilm positive Pseudomonas aeruginosa isolates 17(54.28%) were biofilm positive by tube method, 31(74.28%) by Microtiterplate method (MTP). Out of 66 Pseudomonas aeruginosa isolates 47(71.21%), were Imipenem sensitive and 19(28.78%) were Imipenem resistant. All the 19(100%) Imipenem resistant Pseudomonas aeruginosa isolates were biofilm producers. Conclusion: Majority of Pseudomonas aeruginosa isolates were biofilm producers. Correlation between biofilm production and Imipenem resistance contributes to morbidity and mortality and poor prognosis of patients. Keywords: Biofilm, Pseudomonas aeruginosa, Imipenem resistance, ICU, Antimicrobial resistance

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