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The erratic antibiotic susceptibility patterns of bacterial pathogens causing urinary tract infections

机译:引起尿路感染的细菌性病原体的抗生素敏感性变化规律

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摘要

Increasing trend of antibiotic resistance and expression of Extended Spectrum Beta Lactamases (ESBLs) are serious threats for public health as they render the treatment ineffective. Present study was designed to elucidate the antibiotic-susceptibility patterns of ESBL and non-ESBL producing E. coli and K. pneumoniae causing urinary tract infections so that the ineffective antibiotics could be removed from the line of treatment. The bacterial isolates obtained from the urine of patients visiting a tertiary health care facility were cultured for strain identification using API20E. Antimicrobial susceptibility and ESBL detection were done by Kirby-bauer diffusion technique. Almost 53.4 % isolates of E. coli and 24.5 % isolates of K. pneumoniae were found to be ESBL producers. The ESBL producing bacteria were found to be more resistant towards various antibiotics. The most effective drugs against E. coli ESBL isolates were imipenem (99.54 %), ampicillin-sulbactam (97.48 %), piperacillin-tazobactam (96.86 %), fosfomycin (94.51 %), amikacin (92.26 %) and nitrofurantoin (90.68 %). The most effective drugs against K. pneumoniae ESBL isolates were imipenem (97.62 %), piperacillin-tazobactam (95.35 %), ampicillin-sulbactam (90.48 %) and amikacin (88.37 %). The antibiotics having the highest resistance, particularly by the ESBL producers were amoxicillin clavulanic acid, sulphamethoxalzole/ trimethoprim, cefuroxime, cefpirome, ceftriaxone and ciprofloxacin. Most of the isolates showed multi drug resistance (MDR). High frequency of ESBL producing E. coli and K. pneumoniae were observed as compared to previous data. Penicillins, cephalosporins and some representatives of fluoroquinolones were least effective against the common UTIs and are recommended to be removed from the line of treatment.
机译:抗生素耐药性的增加趋势和超广谱β内酰胺酶(ESBLs)的表达对公共卫生构成严重威胁,因为它们使治疗无效。本研究旨在阐明引起尿路感染的ESBL和非ESBL产大肠杆菌和肺炎克雷伯菌的抗生素敏感性模式,以便将无效的抗生素从治疗中清除。使用API​​20E培养从三级医疗机构就诊的患者尿液中分离得到的细菌分离株。抗菌药敏性和ESBL检测采用Kirby-bauer扩散技术进行。发现有近53.4%的大肠杆菌分离株和24.5%的肺炎克雷伯菌分离株是ESBL生产者。发现产生ESBL的细菌对各种抗生素具有更强的抵抗力。对大肠杆菌ESBL分离物最有效的药物是亚胺培南(99.54%),氨苄青霉素-舒巴坦(97.48%),哌拉西林-他唑巴坦(96.86%),磷霉素(94.51%),阿米卡星(92.26%)和硝基呋喃妥因(90.68%) 。对肺炎克雷伯菌ESBL分离物最有效的药物是亚胺培南(97.62%),哌拉西林-他唑巴坦(95.35%),氨苄西林-舒巴坦(90.48%)和丁胺卡那霉素(88.37%)。耐药性最高的抗生素,特别是ESBL生产商产生的耐药性是阿莫西林克拉维酸,磺胺甲恶唑/甲氧苄啶,头孢呋辛,头孢吡肟,头孢曲松和环丙沙星。大多数分离株表现出多重耐药性(MDR)。与以前的数据相比,观察到产生ESBL的大肠杆菌和肺炎克雷伯菌的频率很高。青霉素,头孢菌素和氟喹诺酮类药物的某些代表对常见的UTI最无效,因此建议从治疗药物中删除。

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