title: Prevalence of extended spectrum beta-lactamase producing uropathogens and their antibiotic resistance profile in patients visiting a tertiary care hospital in central India: Implications on empiric therapy.
abstract: BACKGROUND
  Antimicrobial resistance showed by different uropathogens is one of the barricades that might hinder a successful treatment. Detection of extended spectrum beta-lactamase (ESBL) production among uropathogens is an important marker of endemicity.
  
  
  OBJECTIVE
  The present prospective study was done to identify the trends of uropathogens, to find the prevalence of ESBL isolates and to study the antibiotic resistance profile of the ESBL and non-ESBL uropathogenic isolates.
  
  
  METHODS
  This study was conducted in the Department of Microbiology of a teaching tertiary care hospital from July 2013 to September 2013. All the uropathogenic isolates were identified up to species level by conventional methods. The prevalence of potential ESBL producers was explored. Antibiotic resistance test of the urinary isolates was done by disc-diffusion method and the results were interpreted according to Clinical Laboratory Standards Institute-2013 guidelines.
  
  
  RESULTS
  A total of 670 urine samples from male and female patients visiting the outpatient department (OPD) and inpatient department (IPD) of our hospital were collected. A significantly higher number of IPD and OPD males (55.1% and 55.5%) were found to be culture positive. Escherichia coli (55.3%) was the most frequently isolated uropathogen followed by Klebsiella pneumoniae (23%). However, strains of Escherichia coli (41.6%) were the highest ESBL producing isolates followed by Pseudomonas aeruginosa (36.1%). ESBL producing isolates were found to be multidrug-resistant when compared to non-ESBL producers. However, excessive drug-resistance among non-ESBL producing isolates can't be ignored.
  
  
  CONCLUSIONS
  Our study confirms a global trend toward increased resistance to beta-lactam antibiotics. We emphasize on the formulation of antibiotic policy for a particular geographical area.
authors.affiliation: Department of Microbiology, Sri Aurobindo Institute of Medical Sciences Medical College and PG Institute, Indore, Madhya Pradesh, India.
authors.forename: Trupti
authors.initials: T
authors.lastname: Bajpai
authors.forename: Maneesha
authors.initials: M
authors.lastname: Pandey
authors.forename: Meena
authors.initials: M
authors.lastname: Varma
authors.forename: Ganesh S
authors.initials: GS
authors.lastname: Bhatambare
mesh_terms: D024881:Drug Resistance, Bacterial; D005260:Female; D006090:Gram-Negative Bacteria / Q000201:enzymology* / Q000302:isolation & purification; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology / Q000382:microbiology*; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D062606:Tertiary Care Centers; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000382:microbiology*; D001618:beta-Lactamases / Q000378:metabolism*
chemical_list: D001618:beta-Lactamases