Among prevalent infectious diseases, the most frequently occurring infections are the Urinary Tract Infections (UTIs) which predominantly occur in the community as well as in the hospital settings and are one of the main cause of morbidity and mortality worldwide. Objectives: To determine the frequency of MBL E. coli species in urine samples, antibiotic susceptibility pattern and the prevalence of MDR for E. coli. Methods: There were 200 urine samples obtained from Anwar clinical laboratory Saidu Sharif, District Swat, Pakistan. Samples of urine were obtained and then cultivated in selective media i.e. Cysteine Lactose Electrolyte Deficient Agar (CLED) and MacConkey Agar Plates. In traditional morphological and biochemical studies, isolates were identified. Results: Total 58 (29.6%) positive isolates were recovered from male while 116 (70.3%) urine specimens were positive from female patients, A total isolated bacteria were MBL positive including 36 (31.3%) isolated E. coli, Furthermore, in the total isolated species were identified as MDR positive in which 80 (69.5%) were E. coli, The most potent antibiotics found against bacteria were the highest for Meropenum (78.2%), Imepenum (73.9%), and Amikacin (26.0%) Cefuroxime (21.7%), respectively and Cefaclor (19.1%) were most sensitive while antibiotic mostly resistant showed. Conclusion: This study concludes that, the most prominent bacterial isolate in the urine samples was E. coli 115 (69.6%), Carbapenem resistance is frequently observed isolates of E. coli, which indicate that MBL phenotype should be regularly determined in clinical settings to prevent emerging Carbapenem resistance.
Background: The rate of infections caused by Morganella species is reported to be affected by difficulties in their isolation. Enterobacter, species, Citrobacter freundii, Serratia marcescens, and Morganella morganii are the major pathogens involved in hospital acquired infections. All of them are extensively reported in the infections of urinary tract, respiratory tract, cutaneous disorders, catheter associated infections and infections of the central nervous system.Objective: To investigate the frequency of ESBL producing bacteria in Urinary Tract Infection. Material and Methods: A cross-sectional study of 200 urine samples was collected from the outdoor patient departments of Khyber Teaching Hospital Peshawar through consecutive sampling technique during April, 2019 to June 2019. The urine samples were collected and then cultured on selective media i.e., Cysteine Lactose Electrolyte Deficient Agar (CLED) and on MacConkey agar plates. Isolates were identified by conventional morphological and biochemical tests while antibiotic susceptibility was analyzed by “Agar disc diffusion method” using different antibiotics and their zone of inhibition was measured. Results: Total 200 samples processed, 125 (62.5%) isolates, including 67 (53.6%) females, tested positive for the growth of Gram-negative bacteria. Among the identified species, 76 (60.8%) isolates produced ESBLs, with Escherichia coli accounting for 32.6%, Enterobacter for 23.2%, and Morganella species for 12.0%. Moreover, 77 (61.6%) of the isolates were found to be MBL positive, with 30 (24.0%) of them being E. coli, 28 (22.4%) being Enterobacter, and 19 (15.2%) being Morganella spp. The isolates formed a zone of inhibition like a clover leaf and demonstrated a sensitivity of 85 (68%) to antibiotics in the carbapenem class, such as imipenem and meropenem. Cefoparazone/Sulbactam 80 (64.0%), Ofloxacin 79 (63.2%), and Amikacin 78 (62.4%) were the next three antibiotics with high sensitivity. Ampicillin 106 (84.8%) showed the highest resistance, followed by Nitrofurantoin 84 (67.2%) and Ceftriaxone 79 (63.2%), in that order. Conclusion: The study indicated that ESBL-producing bacteria were present frequently among UTI patients. Most of the isolates exhibited strong carbapenem class antibiotic sensitivity. The findings of this study may contribute to the formulation of tactics to lower the incidence of ESBL-producing UTI.Keywords: Antibiotics resistance, Gram Negative bacteria, Plasmid-mediated enzymes, UTI.
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