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ISSN: Print -2349-0977, Online - 2349-4387
ORIGINAL CONTRIBUTION - CLINICS IN CLINICAL MICROBIOLOGY
Year : 2018  |  Volume : 4  |  Issue : 4  |  Page : 210-216

Antibiotic susceptibility pattern of multidrug-resistant Enterobacteriaceae in urinary isolates and detection of suspected carbapenemase production


Department of Microbiology, Krishna Institute of Medical Sciences Ltd, Secunderabad, Telangana, India

Correspondence Address:
Prasanna L Kakarla
Department of Microbiology, Krishna Institute of Medical Sciences Ltd, Secunderabad, Telangana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/astrocyte.astrocyte_7_18

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Context: Urinary tract infection (UTI) is one of the most common bacterial infections. Multidrug-resistant (MDR) Enterobacteriaceae producing carbapenemases pose a challenge for treatment. The modified Hodge test (MHT) detects carbapenemase production in isolates of Enterobacteriaceae. It is simple, accessible, inexpensive, and recommended by Clinical and Laboratory Standards Institute (CLSI). Aims: (1) To study the antibiotic susceptibility pattern of MDR urinary isolates of Enterobacteriaceae. (2) To determine percentage of carbapenem resistance due to carbapenemase production by using MHT. Settings and Design: Prospective laboratory-based observational cross-sectional study in a tertiary care hospital. Patients and Methods: Urine samples (clean and catheter catch) from both inpatients and outpatients were inoculated on cystine lactose electrolyte deficient agar by semi-quantitative method. Significance of growth was established; identification and susceptibility testing was done by using VITEK 2 compact (bioMerieux). Results were interpreted according to CLSI guidelines. MDR Enterobacteriaceae isolates were identified and further tested by MHT as described by CLSI. Statistical Analysis Used: Data were analyzed using Statistical Package for the Social Sciences version 20 (IBM Inc., SPSS Inc., Chicago, IL, USA) software. Descriptive statistics and Chi-square test were used. P values < 0.05 were considered statistically significant. Results: MDR was noted in 25.79% of Enterobacteriaceae isolates. Escherichia coli and Klebsiella pneumoniae together accounted for 87.3% of MDR isolates. Susceptible antibiotics were colistin (91.02%) and amikacin (51.15%). Pandrug resistance (PDR) was noted in 20 isolates. MHT positivity was noted in 72.3% of isolates. Conclusions: Majority of isolates were MHT positive indicating high carbapenemase production. Low susceptibility profile and occurrence of PDR in this setup deter the use of common empiric treatment for all suspected UTI cases.


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