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

Abstract

Background: Antimicrobial resistance (AMR) is a worldwide disaster to health community. Uropathogenic E.coli is increasingly related with multidrug resistance (MDR), including the resistance to the last resort carbapenems. This study aims to determine the antibiotic resistant pattern and detection of carbapenemase producing imipenem resistant E.coli in Dhaka Medical College and Hospital. Methods: An observational study was done over a period of one year in Dhaka Medical College that involve 280 patients. The gram positive and gram-negative bacteria were identified, their antimicrobial resistant patterns were determined and detection of antimicrobial resistant pattern from urine samples. Results: A total of 280 microorganisms were identified among 83 culture positive cases. The microorganisms identified were 92.77% (n=77) gram negative and 7.23% (n=6) gram positive. Antibiotic susceptibility pattern was determined by double disk method for all the isolated E.coli strains. The most resistance was found against cotrimoxazole (90%) and lowest resistant was found against tigecyline (6.67%). 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 MHT. Genotyping detection of carbapenemase encoding genes among imipenem resistant uropathogenic Esch.coli, out of nine imipenem resistant Esch.coli seven has positive encoding genes where has 55.56% bla NDM-1, 44.44% bla NDM-2 like, 22.22% bla VIM, 22.22% bla OXA-48 and no bla IMP gene. Conclusion: Antimicrobial resistance has become a global issue now a days. So, we should use appropriate antibiotic according to the sensitivity pattern for bacteria to prevent emergence of resistance.