Phenotypic Detection of Carbapenemase Producing Imipenem Resistant Uropathogenic E. coli with Their Antimicrobial Resistance Pattern in Dhaka Medical College

Abstract

 Background: Antimicrobial resistance (AMR) is a worldwide nuisance to health community. Uropathogenic E.coli is increasingly associated with multidrug resistance (MDR), including the resistance to the last resort carbapenems. Objective: This study aims to determine the antimicrobial resistant pattern and detection of carbapenemase producing 
imipenem resistant E.coli in Rajshahi Medical College and Hospital. Methods: A cross-sectional descritive study was performed over a period of one year in Dhaka Medical College that involve 280 patients. The gram positive and gram negative bacteria were isolated, their antimicrobial resistant patterns were determined and detection of antimicrobial
resistant pattern from urine samples. Results: A total of 280 urine samples, 83 were culture positive cases. The microorganisms isolated were 77 (92.77%) gram negative and 6 (7.23%) gram positive. Antimicrobial susceptibility pattern was determined by double disk method for all the isolated E.coli strains. The highest resistance was found against cotrimoxazole (90%) and lowest resistant was found against tigecyline (6.67%). In this study, 71.67% (MDR), 23.33% Extensively drug resistant (XDR) and 5% Pan drug resistance (PDR) Esch.coli were isolated. Phenotypic detection of imipenem resistant Esch.coli, 55.56% carbapenemase producers were detected by DDS test, 66.67% were detected by CD assay and 22.22% were detected by Modified Hodge test (MHT). Conclusion: Antimicrobial resistance has become a global warning now a days. So, appropriate antibiotics should be used according to the sensitivity pattern for bacteria to prevent emergence of resistance.