TMSS Medical College Journal

Background: Escherichia coli is reported to be the major cause of urinary tract infection (UTI). Treatment of UTI is becoming difficult due to increasing trend of antibiotics resistance and this may necessitate up to date knowledge of resistance pattern and also to know the causes of such resistance. Objective: The aim of the study is to explore the possibility of developing MDR and plasmid(extrachromosomal element) in bacterial urine culture Escherichia coli isolates to analyze their susceptibility profile to commonly used antibiotics. Materials & Methods: This study has been carried out in the Department of Microbiology of Rajshahi Medical College & Department of Genetics and Biotechnology of Rajshahi University in the period from july 2014 to 2015. Midstream urine were processed for microscopy and culture. The pathogens were identified by standard methods. Antimicrobial sensitivity was carried out by Kirby-Bauer disc diffusion method according to clinical and laboratory standards institute guidelines. Plasmid DNA was extracted from the MDR Escherichia coli strains following the protocol of Brinboim and Doly (Alkaline lysis method). Agarose gel electrophoresis of the extracted DNA was done in horizontal gel apparatus and photograph was taken. Results: A total of 96 uropathogens were isolated from the indoor and outdoor samples and among them Escherichia coli was the most prevalent isolate 66(68.75%). Drug resistance pattern of these isolates were investigated and Escherichia coli showed variable pattern of susceptibility. Among 66 Escherichia coli, 38 were multidrug resistant (>3 groups of drugs). A total 26 plasmid detected among 38 MDR strains through alkaline lysis method. Plasmid band ranged in size from 3-10 kb, forming a unique banding pattern. Middle ranged plasmid 3 kb&4 kb was found to be present in 54% &10 kb was 46% Escherichia coli isolates. Almost all MDR Escherichia coli isolates contained plasmids and many of them share some common plasmids too. However, their number (plasmid copies) also plays a critical role in imparting various characteristics to the pathogen, such as resistance towards different antibiotics. Conclusion: These results showed the drug resistance pattern & the presence of transferrable elements in these MDR Escherichia coli isolates from urine samples and also find out the probable link between them.

Members of the enterobacteriacae especially Escherichia coli is the important opportunistic pathogen that has shown antimicrobial resistance to most antibiotics. Escherichia coli is the normal flora of the human intestine and therefore easily colonizing the urinary tract, leading cause of urinaty tract infection (UTI). In the United States about 8 million physician visits and more than 1 lac hospital admissions per year are due to UTI. Epidemiological studies showed marked variations in the prevalence of bacteriuria among different population.Four major risk groups of community acquired UTI are school aged girls, sexually active young women and in male with prostatic obstruction.In generally, UTI are more common in female than male in ratio about 2:1 with exceptions of the neonatal period when sexes are equally affected’. Urinary tract infections are mostly caused by Escherichia coli accounting for more than 70% of uncomplicated cases both inpatients & outpatient’.