Extraintestinal Infections due to Escherichia Coli: An Emerging Issue

background: Infections due to Extraintestinal pathogenic Escherichia coli (ExPEC) represent a major but little-appreciated health threat. Proper antibiotic sensitivity testing and judicious use of antibiotics are crucial in treatment of such infections. Aims: This study was done to determine the spectrum of infections caused by ExPEC and their antimicrobial susceptibility pattern. settings and Design: Department of Microbiology, Bowring and Lady Curzon Hospital which is a tertiary care, teaching hospital attached to Bangalore Medical College and Research Institute. This is a prospective study from January 2009 to December 2010. Materials & Methods: A total of 379 E. coli isolates from various extraintestinal infections were studied for the antimicrobial sensitivity. The isolates were processed using standard procedures. All strains of E.coli were tested for antimicrobial susceptibility pattern by modified Kirby Bauer disc diffusion method. The results were interpreted using CLSI guidelines and statistically analyzed. Results: A total of 379 strains of E.coli were isolated from extraintestinal infections. Out of these 253 (66.7%) were from urine, 101 (26.6%) were from pus & exudates, 23 (6.1%) from sputum and 2 (0.5%) from blood. The analysis of drug resistance pattern shows that among 349 isolates of E.coli maximum number 357 (94.2%) were resistant to ampicillin and least, 0(0%) were resistant to carbapenams followed by 59 (15.6%) to netilmicin. Conclusions: This study demonstrates a significant increase in the prevalence of antimicrobial resistance among E.coli isolates. When selecting empirical therapy, in vitro susceptibility patterns must be considered along with other factors, such as expected efficacy, adverse effects, cost, cost-effectiveness, and selection of resistant strains. Extraintestinal Infections due to Escherichia Coli: An Emerging Issue