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Pattern of Antimicrobial Resistance to Escherichia Coli Among the Urinary Tract Infection Patients in Bangladesh

Received: 21 July 2018     Accepted: 14 August 2018     Published: 10 October 2018
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Abstract

Urinary Tract Infection (UTI) is very common in our day-to-day clinical practice. Among all the organisms Escherichia coli (E coli) is the most common but antimicrobial resistance becomes an alarming issue for UTI management now a days. Aim of this study is to assess the pattern of antimicrobial resistance to E coli among the UTI patients in Jashore, Bangladesh. This observational study was conducted from February, 2017 to January, 2018 in the district of Jashore, Bangladesh. We recruited 696 patients of both sex with UTI only infected by E coli. We had excluded the patients with UTI caused by other than E coli, female during menstruation, pregnancy, history of taking antibiotics within last 21 days, catheterization within 1 month and pelvic organ & genito urinary tract surgery within 6 months. Evaluation of antimicrobial resistance was done according to the standard bacteriological methods. Mean age of our study cases was 41.46±17.21 years with the range from 15 to 91 years. More than 85% participants were female with a sex ratio was 8:1.5. Reproductive age group ranged from 21 to 50 years was affected most commonly which constituted approximately two-third of our study. Our study revealed that the maximum antimicrobial resistance to E coli was Cotrimoxazole (95.0%), followed by Ceftazidime (75.7%), Gentamicin (70.3%), Amikacin (69.0%), Imipenam (58.9 %,), Cefixime (58.0%), Ciprofloxacin (57.3%), Azithromycin (56.0%), Cefuroxime (46.6%), Cefotaxime (37.4%), Ceftriaxone (35.2%), Meropenem (32.2%), Nitrofurantion (4.7%). With the high magnitude of antimicrobial resistance to E coli among the UTI patients even with extended generation of Cephalosporins, Carbapenams, Ciprofloxacin, Cotrimoxazole, Azithromycin and Aminoglycosides, our recommendation as first line empirical treatment option in UTI should be Nitrofurantoin due to low resistance pattern.

Published in American Journal of Internal Medicine (Volume 6, Issue 5)
DOI 10.11648/j.ajim.20180605.17
Page(s) 132-137
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2018. Published by Science Publishing Group

Keywords

UTI, E coli, Antibiotic Resistance, Antibiotic Susceptibility

References
[1] Keyhan H, Sedighi S, Mashayekhi B, Fathi M, Mokhtari M. Community Acquired Urinary Tract Infections’ Etiological Organisms and Antibiotics Susceptibility Patterns. Nephro-Urology Monthly. 2017;9(5).
[2] Ahmed MA, Shukla GS, Bajaj HK. Incidence of urinary tract infections and determination of their susceptibility to antibiotics among pregnant women. J. Cell. Sci. Biotechnol. 2016:12-6.
[3] Zalmanovici Trestioreanu A, Green H, Paul M, Yaphe J, Leibovici L. Antimicrobial agents for treating uncomplicated urinary tract infection in women. Cochrane Database Syst Rev. 2010;10.
[4] Sanchez GV, Babiker A, Master RN, Luu T, Mathur A, Bordon J. Antibiotic resistance among urinary isolates from female outpatients in the United States in 2003 and 2012. Antimicrobial agents and chemotherapy. 2016 Feb 16:AAC-02897.
[5] Kulkarni R, Dhakal BK, Slechta ES, Kurtz Z, Mulvey MA, Thanassi DG. Roles of Putative Type II Secretion and Type IV Pilus Systems in the Virulence of Uropathogenic Escherichia coli. Beier D, ed. PLoS ONE. 2009; 4(3):e4752.
[6] Foxman B. The epidemiology of urinary tract infection. Nature Reviews Urology. 2010 Dec;7(12):653.
[7] Merz LR, Guth RM, Fraser VJ. Cost of Antimicrobial Resistance in Healthcare Settings: A Critical Review. InAntimicrobial Resistance 2010 (Vol. 6, pp. 102-119). Karger Publishers.
[8] Laxminarayan R, Chaudhury RR. Antibiotic Resistance in India: Drivers and Opportunities for Action. PLoS Medicine. 2016; 13(3):e1001974.
[9] Kahlmeter G, Åhman J, Matuschek E. Antimicrobial Resistance of Escherichia coli Causing Uncomplicated Urinary Tract Infections: A European Update for 2014 and Comparison with 2000 and 2008. Infectious Diseases and Therapy. 2015; 4(4):417-423.
[10] Swami SK, Liesinger JT, Shah N, Baddour LM, Banerjee R. Incidence of Antibiotic-Resistant Escherichia coli Bacteriuria According to Age and Location of Onset: A Population-Based Study From Olmsted County, Minnesota. Mayo Clinic Proceedings. 2012; 87(8):753-759.
[11] Fasugba O, Mitchell BG, Mnatzaganian G, Das A, Collignon P, Gardner A. Five-Year Antimicrobial Resistance Patterns of Urinary Escherichia coli at an Australian Tertiary Hospital: Time Series Analyses of Prevalence Data. Butaye P, ed. PLoS ONE. 2016; 11(10):e0164306.
[12] Lob SH, Nicolle LE, Hoban DJ, Kazmierczak KM, Badal RE, Sahm DF. Susceptibility patterns and ESBL rates of Escherichia coli from urinary tract infections in Canada and the United States, SMART 2010–2014. Diagnostic microbiology and infectious disease. 2016 Aug 1;85(4):459-65.
[13] Wayne PA. Clinical and laboratory standards institute. Performance standards for antimicrobial susceptibility testing.
[14] Mobley H, Alteri C. Development of a Vaccine against Escherichia coli Urinary Tract Infections. Pathogens. 2015; 5(1):1.
[15] Nicolle LE. Uncomplicated urinary tract infection in adults including uncomplicated pyelonephritis. Urologic Clinics of North America 2008; 35:1–12.
[16] O’Brien V, Hannan T, Schaeffer A, Hultgren S. Are you experienced? Understanding bladder innate immunity in the context of recurrent urinary tract infection. Current Opinion in Infectious Diseases. 2015; 28(1):97–105.
[17] Sharma G, Sharma S, Sharma P, Chandola D, Dang S, Gupta S, et al. Escherichia coli biofilm:development and therapeutic strategies. J Appl Microbiol. 2016 Mar; 1–11.
[18] Abduzaimovic A, Aljicevic M, Rebic V, Vranic SM, Abduzaimovic K, Sestic S. Antibiotic Resistance in Urinary Isolates of Escherichia coli. Materia Socio-Medica. 2016; 28(6):416-419.
[19] Al-Badr A, Al-Shaikh G. Recurrent Urinary Tract Infections Management in Women: A review. Sultan Qaboos University Medical Journal. 2013; 13(3):359-367.
[20] Mohsin R, Siddiqui KM. Recurrent urinary tract infections in females. J Pak Med Assoc. 2010; 60:55–9.
[21] Scholes D, Hooton TM, Roberts PL, Stapleton AE, Gupta K, Stamm WE et al. Risk factors for recurrent urinary tract infection in young women. J Infect Dis. 2000; 182:1177–82.
[22] Franco VMA. Recurrent urinary tract infections. Best Pract & Research Clinical Obstet Gynecol. 2005; 19:861–73.
[23] Ayukekbong JA, Ntemgwa M, Atabe AN. The threat of antimicrobial resistance in developing countries: causes and control strategies. Antimicrobial Resistance and Infection Control. 2017; 6:47.
[24] Shahandashti EF, Javanian M, Kouchaksaraei MM, Yeganeh B, Bijani A, Motevaseli E, et al. Resistance patterns of Escherichia coli causing urinary tract infection. Caspian Journal of Internal Medicine. 2015; 6(3):148-151.
[25] Jorgensen S, Zurayk M, Yeung S, Terry J, Dunn M, Nieberg P, Wong-Beringer A. Emergency department urinary antibiograms differ by specific patient groups. Journal of clinical microbiology. 2017 Jun 14:JCM-00481.
[26] Karlowsky JA, Thornsberry C, Jones ME, Sahm DF. Susceptibility of Antimicrobial-Resistant Urinary Escherichia coli Isolates to Fluoroquinolones and Nitrofurantoin, Clinical Infectious Diseases, 2003; 36(2):183-186.
[27] Zahra N, Rehman K, Aqeel R, Parveen A, Akash MSH. Assessment of urinary tract infection and their resistance to antibiotics in diabetic and non-diabetic patients. Bangabandu Sheikh Mujib Med Univ J, 2016; 9:151-155.
[28] Setu SK, Sattar A, Saleh AN, Roy CK, Ahmed M, Muhammadullah S, et al. Study of Bacterial pathogens in Urinary Tract Infection and their antibiotic resistance profile in a tertiary care hospital of Bangladesh, Bangladesh J Med Microbiol, 2016; 10 (01): 22-26.
[29] Akter T, Mia Z, Shahriar M. Antibiotic Sensitivity of Pathogens Causing Urinary Tract Infection, Bangladesh Pharmaceutical Journal, 2013; 16(1): 53-58.
[30] Alyamani EJ, Khiyami AM, Booq RY, Majrashi MA, Bahwerth FS, Rechkina E. The occurrence of ESBL-producing Escherichia coli carrying aminoglycoside resistance genes in urinary tract infections in Saudi Arabia. Annals of Clinical Microbiology and Antimicrobials. 2017; 16:1.
[31] Jean SS, Coombs G, Ling T, Balaji V, Rodrigues C, Mikamo H, Kim MJ, Rajasekaram DG, Mendoza M, Tan TY, Kiratisin P. Epidemiology and antimicrobial susceptibility profiles of pathogens causing urinary tract infections in the Asia-Pacific region: Results from the Study for Monitoring Antimicrobial Resistance Trends (SMART), 2010–2013. International journal of antimicrobial agents. 2016 Apr 1;47(4):328-34.
[32] Saha S, Nayak S, Bhattacharyya I. Understanding the patterns of antibiotic susceptibility of bacteria causing urinary tract infection in West Bengal, India. Frontiers in Microbiology. 2014; 5:463.
[33] Ojdana D, Sieńko A, Sacha P, Majewski P, Wieczorek P, Wieczorek A, et al. Genetic basis of enzymatic resistance of E. coli to aminoglycosides. Adv Med Sci. 2018; 63(1):9-13.
[34] Kulkarni SR, Peerapur BV, Sailesh KS. Isolation and Antibiotic Susceptibility Pattern of Escherichia coli from Urinary Tract Infections in a Tertiary Care Hospital of North Eastern Karnataka. J Nat Sci Biol Med. 2017; 8(2): 176–180.
[35] Jafri SA, Qasim M, Masoud MS, Rahman M-, Izhar M, Kazmi S. Antibiotic resistance of E. coli isolates from urine samples of Urinary Tract Infection (UTI) patients in Pakistan. Bioinformation. 2014; 10(7):419-422.
[36] Akhtar N, Rahman R, Sultana S. Antimicrobial Sensitivity Pattern of Escherichia coli Causing Urinary Tract Infection in Bangladeshi Patients. American Journal of Microbiological Research, 2016; 4(4):122-125.
Cite This Article
  • APA Style

    Goutam Kumar Acherjya, Keya Tarafder, Rina Ghose, Din Ul Islam, Mohammad Ali, et al. (2018). Pattern of Antimicrobial Resistance to Escherichia Coli Among the Urinary Tract Infection Patients in Bangladesh. American Journal of Internal Medicine, 6(5), 132-137. https://doi.org/10.11648/j.ajim.20180605.17

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    ACS Style

    Goutam Kumar Acherjya; Keya Tarafder; Rina Ghose; Din Ul Islam; Mohammad Ali, et al. Pattern of Antimicrobial Resistance to Escherichia Coli Among the Urinary Tract Infection Patients in Bangladesh. Am. J. Intern. Med. 2018, 6(5), 132-137. doi: 10.11648/j.ajim.20180605.17

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    AMA Style

    Goutam Kumar Acherjya, Keya Tarafder, Rina Ghose, Din Ul Islam, Mohammad Ali, et al. Pattern of Antimicrobial Resistance to Escherichia Coli Among the Urinary Tract Infection Patients in Bangladesh. Am J Intern Med. 2018;6(5):132-137. doi: 10.11648/j.ajim.20180605.17

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  • @article{10.11648/j.ajim.20180605.17,
      author = {Goutam Kumar Acherjya and Keya Tarafder and Rina Ghose and Din Ul Islam and Mohammad Ali and Nazma Akhtar and Rajashish Chakrabortty and Satya Ranjan Sutradhar},
      title = {Pattern of Antimicrobial Resistance to Escherichia Coli Among the Urinary Tract Infection Patients in Bangladesh},
      journal = {American Journal of Internal Medicine},
      volume = {6},
      number = {5},
      pages = {132-137},
      doi = {10.11648/j.ajim.20180605.17},
      url = {https://doi.org/10.11648/j.ajim.20180605.17},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajim.20180605.17},
      abstract = {Urinary Tract Infection (UTI) is very common in our day-to-day clinical practice. Among all the organisms Escherichia coli (E coli) is the most common but antimicrobial resistance becomes an alarming issue for UTI management now a days. Aim of this study is to assess the pattern of antimicrobial resistance to E coli among the UTI patients in Jashore, Bangladesh. This observational study was conducted from February, 2017 to January, 2018 in the district of Jashore, Bangladesh. We recruited 696 patients of both sex with UTI only infected by E coli. We had excluded the patients with UTI caused by other than E coli, female during menstruation, pregnancy, history of taking antibiotics within last 21 days, catheterization within 1 month and pelvic organ & genito urinary tract surgery within 6 months. Evaluation of antimicrobial resistance was done according to the standard bacteriological methods. Mean age of our study cases was 41.46±17.21 years with the range from 15 to 91 years. More than 85% participants were female with a sex ratio was 8:1.5. Reproductive age group ranged from 21 to 50 years was affected most commonly which constituted approximately two-third of our study. Our study revealed that the maximum antimicrobial resistance to E coli was Cotrimoxazole (95.0%), followed by Ceftazidime (75.7%), Gentamicin (70.3%), Amikacin (69.0%), Imipenam (58.9 %,), Cefixime (58.0%), Ciprofloxacin (57.3%), Azithromycin (56.0%), Cefuroxime (46.6%), Cefotaxime (37.4%), Ceftriaxone (35.2%), Meropenem (32.2%), Nitrofurantion (4.7%). With the high magnitude of antimicrobial resistance to E coli among the UTI patients even with extended generation of Cephalosporins, Carbapenams, Ciprofloxacin, Cotrimoxazole, Azithromycin and Aminoglycosides, our recommendation as first line empirical treatment option in UTI should be Nitrofurantoin due to low resistance pattern.},
     year = {2018}
    }
    

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  • TY  - JOUR
    T1  - Pattern of Antimicrobial Resistance to Escherichia Coli Among the Urinary Tract Infection Patients in Bangladesh
    AU  - Goutam Kumar Acherjya
    AU  - Keya Tarafder
    AU  - Rina Ghose
    AU  - Din Ul Islam
    AU  - Mohammad Ali
    AU  - Nazma Akhtar
    AU  - Rajashish Chakrabortty
    AU  - Satya Ranjan Sutradhar
    Y1  - 2018/10/10
    PY  - 2018
    N1  - https://doi.org/10.11648/j.ajim.20180605.17
    DO  - 10.11648/j.ajim.20180605.17
    T2  - American Journal of Internal Medicine
    JF  - American Journal of Internal Medicine
    JO  - American Journal of Internal Medicine
    SP  - 132
    EP  - 137
    PB  - Science Publishing Group
    SN  - 2330-4324
    UR  - https://doi.org/10.11648/j.ajim.20180605.17
    AB  - Urinary Tract Infection (UTI) is very common in our day-to-day clinical practice. Among all the organisms Escherichia coli (E coli) is the most common but antimicrobial resistance becomes an alarming issue for UTI management now a days. Aim of this study is to assess the pattern of antimicrobial resistance to E coli among the UTI patients in Jashore, Bangladesh. This observational study was conducted from February, 2017 to January, 2018 in the district of Jashore, Bangladesh. We recruited 696 patients of both sex with UTI only infected by E coli. We had excluded the patients with UTI caused by other than E coli, female during menstruation, pregnancy, history of taking antibiotics within last 21 days, catheterization within 1 month and pelvic organ & genito urinary tract surgery within 6 months. Evaluation of antimicrobial resistance was done according to the standard bacteriological methods. Mean age of our study cases was 41.46±17.21 years with the range from 15 to 91 years. More than 85% participants were female with a sex ratio was 8:1.5. Reproductive age group ranged from 21 to 50 years was affected most commonly which constituted approximately two-third of our study. Our study revealed that the maximum antimicrobial resistance to E coli was Cotrimoxazole (95.0%), followed by Ceftazidime (75.7%), Gentamicin (70.3%), Amikacin (69.0%), Imipenam (58.9 %,), Cefixime (58.0%), Ciprofloxacin (57.3%), Azithromycin (56.0%), Cefuroxime (46.6%), Cefotaxime (37.4%), Ceftriaxone (35.2%), Meropenem (32.2%), Nitrofurantion (4.7%). With the high magnitude of antimicrobial resistance to E coli among the UTI patients even with extended generation of Cephalosporins, Carbapenams, Ciprofloxacin, Cotrimoxazole, Azithromycin and Aminoglycosides, our recommendation as first line empirical treatment option in UTI should be Nitrofurantoin due to low resistance pattern.
    VL  - 6
    IS  - 5
    ER  - 

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Author Information
  • Upazila Health Complex, Bagherpara, Jashore, Bangladesh

  • Department of Microbiology, Jashore Medical College & Hospital, Jashore, Bangladesh

  • Department of Gynaecology and Obstretics, Jashore Medical College & Hospital, Jashore, Bangladesh

  • Department of Microbiology, Jashore Medical College & Hospital, Jashore, Bangladesh

  • Department of Hematology, National Institute of Cancer Research and Hospital, Dhaka, Bangladesh

  • Emergency Department, National Institute of Cardiovascular Disease, Dhaka, Bangladesh

  • Department of Medicine, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh

  • Department of Medicine, Mymensingh Medical College & Hospital, Mymensingh, Bangladesh

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