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INTRODUCTION: Urinary tract infections (UTIs) remain as the most common infection. Catheter-associated (CA) UTI can lead to bacteremia and thereby is the leading cause of morbidity and mortality in hospitalized patients in our country. AIMS AND OBJECTIVES: This study aims to check the prevalence of CAUTI and study the phenotypic and genotypic characters of the multidrug-resistant organisms in a tertiary care hospital, with special reference to NDM-1 and OXA-23. MATERIALS AND METHODS: A total of 231 urine samples from patients with CA-UTI in different wards in a tertiary care hospital over a period of 3 months between June and August 2018 were collected and processed following the standard protocol. Antibiotic susceptibility tests were performed by disk-diffusion method. Modified Hodge test (MHT) was done to isolate carbapenem-resistant isolates, and polymerase chain reaction was done to detect NDM-1 and OXA-23. RESULTS: Out of 231 samples, 101 samples yielded significant growth. These 38 samples were Gram-negative bacilli which were resistant to carbapenems. Out of the 38 which showed carbapenem resistance, 23 were MHT positive. Out of the 23 MHT-positive isolates, 8 (21.05%) were positive for NDM-1 gene and only 1 (2.6%) was positive for the OXA-23 gene. CONCLUSION: This study has shown that carbapenem-resistant isolates from all the CA urinary tract-infected patients were 52.77% and most of them were Klebsiella. About 21% of them harbored the NDM-1 gene whereas only 2% had the OXA-23 gene. There has been an alarming increase in the spread of carbapenem resistance.
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INTRODUCTION: Urinary tract infections (UTIs) are very common. Indiscriminate use of antibiotics has led to the development of resistance to most of the commonly used antibiotics including quinolones. AIM: This study aimed to find out the prevalence of ciprofloxacin resistance among the uropathogenic Enterobacteriaceae, to determine the virulence factors of these isolates, and to detect the aac-(61)-lb-cr gene among those isolates with minimal inhibitory concentrations (MICs) of ciprofloxacin >256 mcg/ml. MATERIALS AND METHODS: Urine samples reaching the microbiology laboratory were processed, pathogens belonging to the Enterobacteriaceae family were isolated from those with significant bacteriuria, and antibiotic sensitivity testing was performed according to the CLSI guidelines. MIC of ciprofloxacin for the isolates resistant to ciprofloxacin was determined by using the E-test, and virulence factors such as hemagglutination, hemolysis, and mucoid colonies were analyzed. aac-(61)-lb-cr gene was analyzed by polymerase chain reaction for those isolates with MIC > 256 mcg/ml. RESULTS: Escherichia coli was the most common isolate (62%) with the highest ciprofloxacin resistance (68%). Fourteen percent of them had MIC > 256 mcg/ml and all of these isolates harbored the aac-(61)-lb-cr gene. CONCLUSION: Plasmid-mediated drug resistance can rapidly spread and lead to selection of drug-resistant mutants if not controlled.