AmpC and extended spectrum beta-lactamases production among urinary isolates from a tertiary care hospital in Lalitpur, Nepal

Abstract

BackgroundProduction of AmpC and extended spectrum beta-lactamases among urinary isolates has created a serious problem to the successful management of the urinary tract infection. The main purpose of this study was to determine the rates of the extended spectrum beta-lactamase (ESBL) production and AmpC beta-lactamase (ABL) production among urinary isolates.ResultsAmong total 564 urinary isolates, 514 (91.1%) were gram negative bacilli and 50 (8.9%) were gram positive cocci. E. coli (76.1%) was the most common bacteria isolated. Staphylococcus aureus (6.7%) was the predominant gram positive bacteria isolated. 35 (6.8%) of the 514 gram negative bacilli were ESBL producers. Similarly, 14 (2.7%) of the gram negative bacilli were ABL producers. Only one isolate was ESBL and ABL co-producer. Highest rate of susceptibility of gram negative bacteria was seen toward amikacin (97.3%) followed by imipenem (94.4%). Similarly, highest rate of susceptibility among gram positive cocci was seen toward vancomycin (100%) followed by amikacin (93.5%).ConclusionsLow rates of AmpC and extended spectrum beta-lactamases production in comparison to other previous studies were reported. On the basis of the antimicrobial susceptibility patterns of the bacteria we reported in our study, amikacin, imipenem and nitrofurantoin can be used for the preliminary treatment of urinary tract infections caused by gram negative bacteria and vancomycin and amikacin for treatment of urinary tract infections caused by gram positive bacteria.

Extended Spectrum Beta-Lactamase (ESBL) producing Escherichia coli and Klebsiella species in pediatric patients visiting International Friendship Children's Hospital, Kathmandu, Nepal

“…Another study reported 35.9% ESBL in E. coil isolates among outpatients at tertiary care hospital in Kathmandu [18]. However, similar study from Lalitpur district reported 6.8% ESBL producing isolates [19]. Studies have shown the wide range in prevalence of ESBLs (10 to 43%) in different hospitals/settings from various samples.…”

“…Several studies in the past have investigated the prevalence of ESBL organisms among inpatients mostly focused in adult patients [7,18,19]. Studies have shown the varying prevalence of ESBL organisms, for instance, the prevalence was 27.7% in Pokhara [7], 18% in Kathmandu [20], 43% in pediatric hospital in Kathmandu [21].…”

Plasmid Profiling and Occurrence of β-lactamase Enzymes in Multi-drug Resistant Uropathogenic Escherichia coli in Kathmandu, Nepal

“…Another study reported 35.9% ESBL in E. coil isolates among outpatients at tertiary care hospital in Kathmandu [22]. However, similar study from Lalitpur district reported 6.8% ESBL producing isolates [23]. Studies have shown the wide range in prevalence of ESBLs (10 to 64%) in different Hospitals/settings from various samples.…”

Extended-Spectrum β-Lactamase-Producing Escherichia coli and Klebsiella Species in Pediatric Patients Visiting International Friendship Children’s Hospital, Kathmandu, Nepal

“…Several studies in the past have investigated the prevalence of ESBL organisms among inpatients, mostly focused in adult patients. [11][12][13] Studies have shown the varying prevalence of ESBL organisms, for instance, the prevalence was 27.7% in Pokhara, 11 18% in Kathmandu, 14 43% in pediatric hospital in Kathmandu. 15 Another study reported 35.9% ESBL in E coil isolates among outpatients at tertiary care hospital in Kathmandu.…”

“…12 However, similar study from Lalitpur district reported 6.8% ESBL-producing isolates. 13 Studies have shown the wide range in the prevalence of ESBLs (10%-43%) in different hospitals/settings from various samples.…”