Frequency of carbapenem resistant uro-pathogenic Escherichia Coli in ICU patients of a tertiary Care Hospital of Southern Punjab

Background: Urinary tract infections in ICU patients is widespread and carbapenem resistant uropathogenic Escherichia Coli in ICU admitted catheterized patients is alarming. To determine the frequency of carbapenem resistant UPEC in ICU patients of a tertiary care hospital in southern Punjab. Material and Methods: This cross-sectional study was done at Microbiology laboratory of Nishtar Medical University Multan, Pakistan from 01 March 2021 to 31 December 2021. A total of 367 urine samples were taken from patients admitted in ICU department. Urine samples were inoculated on CLED agar according to standard protocols and 160 E. coli were recognized with traditional biochemical tests. According to CLSI 2020 standards, the antimicrobial profile of isolates against carbapenems were determined using the Kirby-Bauer disc diffusion method, and carbapenemase production was determined by using the Modified Hodge test. All data was entered and analyzed in SPSS 26 version. Results: 271 samples (73.84%) were found positive for urinary tract infections while other 96 (26.15%) samples were found negative for UTIs. Among all the causative agents, E. coli (n=160) was the most commonly isolated organism. Its prevalence was pointedly higher in male, as 84 (52.5%) and 76 (47.5%) were isolated from males and females respectively. A total of 19 (11.88%) isolates of E. coli were carbapenem resistant. Further, 89.47% carbapenem resistant isolates were positive for MHT while rests were negative. Conclusion: Carbapenem resistance is alarming in UPEC among the patients admitted in ICU department, mainly due to carbapenemase enzyme. Keywords: CLED, Carbapenem resistant, ICU, UTI, Uropathogenic E. coli.