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首页> 外文期刊>Journal of Clinical and Diagnostic Research >Multidrug-Resistance and Extended Spectrum Beta-Lactamase Production in Uropathogenic E. Coli which were Isolated from Hospitalized Patients in Kolkata, India
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Multidrug-Resistance and Extended Spectrum Beta-Lactamase Production in Uropathogenic E. Coli which were Isolated from Hospitalized Patients in Kolkata, India

机译：从印度加尔各答住院患者中分离出的致病性大肠杆菌中的多药耐药性和广谱β-内酰胺酶生产

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Background and Objective: Urinary Tract Infections (UTIs) are mostly caused by Escherichia coli. The appropriate therapy demands a current knowledge on the antimicrobial susceptibility pattern amongst these pathogens, as an inappropriate use of antibiotics may lead to complications and treatment failure. The UTIs which are caused by multidrug resistant Extended-Spectrum Beta-Lactamase (ESBL) producing bacteria further pose a severe problem, as the treatment options are limited. The aim of this study was to identify the pattern of multi drug resistance amongst the uropathogenic E. coli (UPEC) isolates which were obtained from hospitalized patients.Materials and Methods: Forty UPEC were isolated from 200 urine samples of hospitalized patients who were clinically suspected for UTIs. Antimicrobial susceptibility screening was performed by using 16 antibiotics, by the Kirby Bauer disk diffusion technique. The isolates which were resistant to the third generation cephalosporins were subjected to the ESBL confirmatory test by using drug and drug-inhibitor combination disks by following the CLSI guidelines.Results: All the 40 isolates except three were multidrug resistant. They showed the highest sensitivities for nitrofurantoin (72.5%) and amikacin (70%). A high level of resistance was observed against ampicillin (97.5%), nalidixic acid and cefelexin (95%), amoxicillin (92.5%), cotrimoxazole (82.5%) and ciprofloxacin (80%) respectively. Thirty different antibiotic resistance patterns were observed against the different antibiotics. Twenty-eight out of the 40 isolates were resistant to the third generation cephalosporins. However, the phenotypic test for the ESBL confirmation indicated that eighteen out of the twenty-eight isolates were ESBL producers and that eleven different drug resistance patterns were observed amongst them.Conclusions: Therefore, this study accounts for the varied multidrug resistance pattern amongst the uropathogenic E. coli which were isolated from hospitalized patients in Kolkata, an eastern region of India. Nitrofurantoin and amikacin should be assigned as potent drugs to treat this infection in this region of the country. These varied resistance patterns present major therapeutic and infection control challenges and they suggest a heterogeneous population of the uropathogenic E. coli isolates which circulate in this sector of India.
机译：背景与目的：尿路感染（UTI）主要由大肠杆菌引起。适当的治疗方法需要对这些病原体中的抗生素敏感性模式有最新的了解，因为不当使用抗生素可能会导致并发症和治疗失败。由多药耐药性广谱β-内酰胺酶（ESBL）产生细菌引起的尿路感染还存在严重问题，因为治疗方法有限。这项研究的目的是确定从住院患者中获得的尿路致病性大肠杆菌（UPEC）分离株中的多药耐药模式。材料和方法：从200例临床怀疑的住院患者尿液中分离出40种UPEC。用于UTI。通过Kirby Bauer纸片扩散技术，使用16种抗生素进行了药敏试验。按照CLSI指南，使用药物和药物-抑制剂组合磁盘对第三代头孢菌素耐药的菌株进行ESBL确认试验。结果：除3株外，其余40株均具有多重耐药性。他们对呋喃妥因（72.5％）和丁胺卡那霉素（70％）的敏感性最高。观察到分别对氨苄西林（97.5％），萘啶酸和头孢氨苄（95％），阿莫西林（92.5％），可曲唑（82.5％）和环丙沙星（80％）的高水平耐药性。观察到针对不同抗生素的三十种不同抗生素抗性模式。在40个分离物中，有28个对第三代头孢菌素具有抗性。然而，对ESBL确认的表型测试表明，在28个分离株中有18个是ESBL产生者，在其中观察到11种不同的耐药模式。结论：因此，本研究解释了尿路致病菌中多种药物耐药性模式的差异从印度东部加尔各答的住院患者中分离出的大肠杆菌。应当将呋喃妥因和丁胺卡那霉素指定为治疗该国该地区感染的有效药物。这些不同的抗药性模式带来了主要的治疗和感染控制挑战，并且它们提示了在印度这一领域流行的尿毒原性大肠杆菌分离株的异质种群。

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