URINARY TRACT INFECTION BY ESHERICHIA COLI IN PATIENTS ATTENDING TERTIARY CARE HOSPITAL OF CENTRAL INDIA

Introduction: The most common infectious disease encountered in the community in all age group is Urinary tract infection (UTI) and usually empirical antibiotic therapy is given depending upon the common causative agent and their susceptibility to commonly used antibiotic. More than 70% of the UTIs are caused by the Enterobacteriaceae group, of which Escherichia coli (E. coli) accounts for around 80% of the cases. UTI is commonly seen in female patients, within all age group because of the short urethra and the incidence increases with the increase in the age. Changing pattern of UTI and its etiology has been studied in the various studies. Therefore constant monitoring of the antimicrobial resistance is necessary for specific micro-organisms in their specific environment. Material And Methods: This study was retrospective observational study which includes all the patients attending Out Patient Department (OPD) with UTI symptoms and confirmed by positive urine culture. Demographic and socioeconomic data was collected from the medical records of all the patients. Mid-stream urine sample was obtained from al the patients. Samples were tested by using microscopy, culture and isolation, and biochemical tests for the identification of isolates. Antibiotic sensitivity pattern was obtained by using Kirby- Bauer disc diffusion method. ESBL (extended Spectrum Beta lactamase) production was determined on MHA by Kirby Bauer disc diffusion method as per recommendation of CLSI. Results: Of the total 988 samples 355 (35.93%) samples showed significant growth of organisms and were included in the study. Of the 355 positive cultures 248 (69.86%) were female while 107 (30.14%) were male. Of the 355 isolates the most frequent isolate was E. coli 89 (25.07%) followed by Klebsiella pneumoniae 59 (16.62%). Proteus species was isolated from 47 (13.24%) cases, Enterococcus species from 46 (12.96%), CoNS(Coagulase Negative Staphylococci) from 44(12.39%), Staphylococcus aureus from38 (10.70%), pseudomonas aeruginosa from 15 (4.23%0, Candida albicans from 10 (2.28%) and Streptococcus species from 7 (1.97%) cases. E coli showed high resistance to ampicillin (94.38%), cefotaxime (66.29%), Cefuroxime (60.67%), imipenem (51.69%) and cotrimoxazole (52.81%). E coli isolates were least resistant to amikacin (5.62%) followed by gentamycin (6.74%) and nitrofurantoin (10.11%). Resistance to amoxicillin-clavulanate was 13.48%. ESBL production was observed in 9 (10.11%) of the E. coli isolates. Conclusion: E. coli (25.07%) is the most common uropathogens in urine culture. ESBL production by E. coli was 10.11%. Most of the isolates of E. coli were multidrug resistant showing high resistant to ampicillin and most were sensitive to amikacin (5.62%).Empirical and uncontrolled used of antibiotics should be checked and regular studies should be carried out to look for the pattern of antimicrobial resistance in particular area or community.