Kakatiya University, India
Dr.Gadangi Indira has completed her PhD FROM Kakatiya University in Medical Microbiology On dermatophytosis. She is an Associate Professor and HOD of Department of Microbiology in Pingle Govt College for Women, Warangal, Telangana State, India.At present she is working on a major research project funded by U.G.C. She has published papers in both National and International journals and a reviewer for a reputed journal.
ESBL group of organisms are beta lactamase enzyme producing organisms capable of breaking the beta lactam ring in antibiotics hence are resistant to usually cephalosporins and few other antibiotics. In these E.coli is the most common bacteria that lives in gut harmlessly but causes Urinary tract infection and in severe cases blood poisoning, septicemia or bacteremia leading to serious sepsis. When not treated it leads to inflammation of body parts, blood clots, blocking oxygen supply andultimately causing death. In present study report a 51 years old Indian tourist patient was admitted in a Wake Med Health hospital at USA, with symptoms of UTI.In hospital she was diagnosed with ESBL E.coliUTI infection with>100,000 colonies /ml and blood culture showed positive result. In this case the Sepsiswas resulted as secondary infection. She even suffered with chronic anemia. The previous medical history of subject showed several risk factors for acquisition of infection. These include elder age, female gender,chronic anemia, recent hospitalization, surgical procedure (due to hysterectomy), intravenous catheterization, intensive careand prolonged usage of high potency antibiotics.All these factors are established as predictive and prognostic risk factors for acquisition of infection and also results in colonization of organism. The antibiotic sensitivity test was done by using CLSI, MIC method on Ampicillin, Cefazolin, Cefepime, Celfazidine, Celtriaxone, Ciprofloxacin,Levofloxacin,Tobramycin showed resistant, Nitroflurantoin showed semi resistant andErtapenem, gentamicin,Amikacin showed susceptibility. Hence the subject was treated with Doripenemas Intra Venous administration for 15 days with the help of a peripherally inserted central catheteri.e., PICC line.In this case study report,the excessive usage of high dose antibiotics for longer period made the organism resistant or immune. This factor was considered as the primary risk factor followed by hospitalization and gender. In conclusion the study of risk factors help in identification of high-risk cases of UTI positive infection. But still individualization is needed for identification of risk factors.The drug used for the treatment is expensive and often not available in developing countries. The drug sensitivity tests helps in establishing an empirical antibiotic policy.