Extended Spectrum Beta Lactamases Detection and Multiple Antibiotic Resistance Indexing of Escherichia Coli from Urine Samples of Patients from a Referral Hospital of Eastern Nepal

Chakrawarti, A.; Dongol, Pranita; Khanal, Hemanta; Subba, Prince; Benerjee, J.J.

doi:10.3126/ijasbt.v3i3.12924

Cited by 7 publications

(7 citation statements)

References 13 publications

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“…A study by Ghimire et al [ 21 ] and Yadav et al [ 46 ] recorded 96.8% and 82.5% of the isolates as MDR, respectively. Guragain et al [ 39 ], Chakravarti et al [ 47 ], and Sharma et al [ 48 ] reported a lower MDR rate than ours in urinary E . coli and K .…”

Section: Discussioncontrasting

confidence: 39%

Prevalence of multidrug-resistant and extended-spectrum beta-lactamase producing Gram-negative isolates from clinical samples in a tertiary care hospital of Nepal

et al. 2021

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Background The existence of multidrug-resistant organisms, including extended-spectrum beta-lactamases (ESBLs), is on rise across the globe and is becoming a severe problem. Knowledge of the prevalence and antibiogram profile of such isolates is essential to develop an appropriate treatment methodology. This study aimed to study the prevalence of Gram-negative isolates exhibiting ESBL at a tertiary care hospital and study their antibiogram profile. Methods A cross-sectional study was conducted at Shahid Gangalal National Heart Centre, Kathmandu, Nepal, from June 2018 to November 2018. A total of 770 clinical samples were collected and identified using the conventional biochemical tests following the Clinical and Laboratory Standard Institute (CLSI) guidelines. Antimicrobial susceptibility testing (AST) was performed using the standardized Kirby-Bauer disk diffusion method. The screening test for ESBL producers was performed as recommended by the CLSI and the confirmatory test was performed phenotypically using the E-test. Results Out of the 92 isolates, 84 (91.3%) were multidrug-resistant, and 47 (51.1%) were found to be potential ESBL producers. Of these, 16 isolates were confirmed ESBL producers by the E-test. Escherichia coli and Klebsiella pneumoniae were the predominant isolates and were also the major ESBL producers. Besides polymyxin B (100% sensitive), meropenem and imipenem showed high efficacy against the ESBL producers. Conclusion Multidrug resistance was very high; however, ESBL production was low. Polymyxin B and carbapenems are the choice of drugs against ESBL producers but should be used only as the last line drugs.

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Section: Discussioncontrasting

confidence: 39%

Prevalence of multidrug-resistant and extended-spectrum beta-lactamase producing Gram-negative isolates from clinical samples in a tertiary care hospital of Nepal

et al. 2021

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“…The disks were placed 20 mm apart. A > 5 mm increase in a zone diameter for antimicrobial agent tested in combination with clavulanic acid versus its zone when tested alone are ESBL producers [17,24] .…”

Section: Combined Disk Methodsmentioning

confidence: 99%

Detection of Extended-Spectrum Beta Lactamases and AmpC Beta Lactamases Producing Uropathogenic Escherichia coli in a Tertiary Care Hospital

Bakshi

Sehgal

Kansal

et al. 2019

International Journal of Medical and Dental Sciences

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Background: The multidrug resistant among uropathogenic E. coli has become a potential threat to global health. The aim of the current study to evaluate the antimicrobial activities of nitrofurantoin and fosfomycin along with other antimicrobials against Extended Spectrum β-Lactamases (ESBL) and AmpC producer isolates from the most common organism E. coli. Methods: A total of 6046 clean catch midstream urine samples were collected and processed in Microbiology department of tertiary care hospital. The antimicrobial susceptibility of E. coli isolates was initially screened by Kirby-Bauer disk diffusion method. The resistant isolates were confirmed to be ESBL and AmpC producers by their respective phenotypic confirmatory tests of combined disc method. Results: Out of 6046 patients there were 1855 E. coli positive patients. Maximum patients in the age group of 21-30 years were 51.5% followed by 31-40 years where patients were 26%. 64.4% E. coli were isolated from female patients and 35.6% from male patients. E. coli showed higher sensitivity towards, fosfomycin (100%), imipenem (100%), nitrofurantoin (84.1%), piperacillin and tazobactam (77.3%), amikacin (76.1%) and while they showed high degree resistance pattern against Penicillin, cotrimoxazole, ciprofloxacin, norfloxacin and 2 nd and 3 rd generation cephalosporin. Out of 1855 E. coli, multi drug resistance was seen in 520 E. coli isolates. ESBL production was observed among 50% of E. coli isolates by combined disk method. Out of 520 isolates, 150 isolates showed resistance to one or more extended-spectrum cephalosporins and cefoxitin by Kirby-Bauer disk diffusion method. These were selected and screened for ESBL and AmpC production. Among 150 cefoxitin-resistant isolates, AmpC phenotype was detected in 100 isolates (66.6%) by AmpC disc method. The overall occurrence of AmpC in the study was found to be 19.2%. Susceptibility of ESBL and AmpC producers to fosfomycin, imipenem, nitrofurantoin and amikacin were found to be 100%, 98.5%, 89% and 75% respectively. Conclusions: There is increased prevalence of ESBL and AmpC producing E. coli. Thus, early detection of ESBL and AmpC producer E. coli by simple phenotypic methods is necessary to avoid treatment failure, where molecular techniques are not available.

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“…However, a low resistance rate in both ESBL positive and negative E. coli were demonstrated against amikacin, imipenem and nitrofurantoin, In pregnant women, the MDR mean value was significantly (t=4.26, P=0.0001) higher in ESBL producer E. coli (6.38±1.13) than that in ESBL negative E. coli (5.09±1. 19). In addition, in diabetic women, the MDR mean value was significantly (t=3.41, P=0.0013) higher in ESBL producer E. coli (6.92±0.98) than that in ESBL negative E. coli (5.75±1.22).…”

Section: Resultsmentioning

confidence: 99%

“…In a recent study in Erbil, Iraq [8], MDR was more predominant in ESBL positive E. coli than in ESBL negative isolates and 71.89% of ESBL positive isolates show MDR of ≥5 antibiotic groups, while the corresponding value in ESBL negative was 40%. Cruz et al [29], 2014, Philippines, reported that MDR to 4 antibiotic groups, while Chakrawarti et al, [19], 2015, Nepal, reported nine MDR patterns for E. coli isolates. In addition, Aka and Haji, [40], 2015, Erbil, Iraq, reported that they found MDR more frequent in ESBL positive E. coli isolates; however, their data are multiple antibiotic resistance number and not MDR trend.…”

Section: Discussionmentioning

confidence: 99%

“…One of the risk factors related to the causative agents of UTI is the ability of the bacteria to produce extended spectrum beta lactamase [ESBL] [8][9][10][11][12][13][14]. The ESBL producing organisms are with global distribution, and they increased with time and varied geographically [15][16][17][18][19][20] . Additionally, study population is influenced aetiology of UTI and antibiotic susceptibility and response to treatment [21,22].…”

Section: Introductionmentioning

confidence: 99%

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Comparison of Antibiotic Sensitivity between Extended Spectrum Beta Lactamase Producers and ESBL Negative Escherichia coli Clinical Isolates

Alsamarai¹,

Ali

2018

IJMS

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Background: Recurrent urinary tract infection [UTI] and treatment failure were common challenges in the control of UTI in Iraqi community. Objective: To determine the difference in antibiogram and multidrug resistance between ESBL positive and negative E. coli clinical isolates. Materials and methods: prospective cross-sectional study was conducted during the period from 1st of June 2015 to the end of January 2016. The study population was 563 women, of them 425 [75.5%] were outpatients, and 138 [24.5%] were inpatients. Their age range was between 18 and 80 years, with a mean age of 33.59±15.29 years. Urine samples were immediately cultured on blood agar and MacConkey agar by spread plate technique. Bacterial colonies with different morphology were selected, purified and identified according to their biochemical characteristics using conventional standard methods. Results: The rate of resistance was higher in ESBL positive as compared to ESBL negative producers E. coli isolates for all tested antibiotics. A high rate of resistance was demonstrated by most of the tested antibiotics. A low resistance rate in both ESBL positive and negative E. coli were demonstrated against amikacin, imipenem and nitrofurantoin. ESBL producer E. coli isolates were resistant to ≥5 of MDR in 98% of isolates [92/94], while the corresponding value was 71% [29/41], while MDR to ≥7 was 56% [53/94] in ESBL producer and 17% [7/41] in ESBL none producer E. coli. Conclusion: ESBL producing was of significant influence on the emergence of resistance in E. coli clinical isolates

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Extended Spectrum Beta Lactamases Detection and Multiple Antibiotic Resistance Indexing of Escherichia Coli from Urine Samples of Patients from a Referral Hospital of Eastern Nepal

Cited by 7 publications

References 13 publications

Prevalence of multidrug-resistant and extended-spectrum beta-lactamase producing Gram-negative isolates from clinical samples in a tertiary care hospital of Nepal

Prevalence of multidrug-resistant and extended-spectrum beta-lactamase producing Gram-negative isolates from clinical samples in a tertiary care hospital of Nepal

Detection of Extended-Spectrum Beta Lactamases and AmpC Beta Lactamases Producing Uropathogenic Escherichia coli in a Tertiary Care Hospital

Comparison of Antibiotic Sensitivity between Extended Spectrum Beta Lactamase Producers and ESBL Negative Escherichia coli Clinical Isolates

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