Multidrug resistant Enterobacteriaceae and extended spectrum β-lactamase producing Escherichia coli: a cross-sectional study in National Kidney Center, Nepal

Abstract

BackgroundEmergence of antibacterial resistance and production of Extended spectrum β-lactamases (ESBLs) are responsible for the frequently observed empirical therapy failures. Most countries have experienced rapid dissemination of ESBLs producing Enterobacteriaceae isolates, particularly E. coli and Klebsiella pneumoniae. ESBLs are clinically significant and when detected, indicate the need for the use of appropriate antibacterial agents. But antibacterial choice is often complicated by multi-resistance.MethodsThis study was carried from June to November 2014 to study the multidrug resistant (MDR) Enterobacteriaceae and ESBL producing E. coli among urine isolates in hospital setting. Isolates from urine samples were primarily screened for possible ESBL production followed by phenotypic confirmation. Antibiotic susceptibility testing (AST) was done by Kirby Bauer disk diffusion method following Clinical and Laboratory Standard Institute (CLSI) guidelines.ResultsOut of 450 urine samples processed, 141 significant growths were obtained including 95 Enterobacteriaceae isolates with 67 E. coli. Among Enterobacteriaceae, 92 (96.84 %) were recorded as MDR and 18 (26.87 %) E. coli were confirmed as ESBLs producers.ConclusionsUsing the phenotypic confirmatory test forwarded by the CLSI, relatively significant E. coli isolates tested were ESBL producers. Also high numbers of MDR organisms were isolated among Enterobacteriaceae. Isolates showed significant resistance to the commonly prescribed drugs. These findings suggest for further study in this field including the consequences of colonization with MDR and ESBL-producing bacteria both in the community and in the hospital setting.

ESBL Production Among E. coli and Klebsiella spp. Causing Urinary Tract Infection: A Hospital Based Study

“…This accords with other studies [21, 22, 24, 28-34]. However, discords with following studies [35-38]. …”

“…The findings are in agreement with the study [11], however, contrary to the findings of other study [47] of 365 E. coli isolates, 33 (9.0%) were ESBL producers. This accords with the other studies [33, 35, 41, 48], however, discords with following studies [22, 24, 29-32, 36-38]. Likewise, of 20 Klebsiella spp.…”

Detection of Metallo-?-Lactamasesencoding Genes Among Clinical Isolates of Escherichia Coli in a Tertiary Care Hospital, Malaysia

“…Misappropriation of antibiotic is liable for the higher incidence of antibiotic resistance among bacteria(Neupane et al, 2016). In this study, 65% E. coli isolates were multidrug resistant which are in agreement with a number of studies, 95.52%(Yadav et al, 2015), 73.68%(Thakur et al, 2013), 57.3%(Nairoukh et al, 2018) and 40.7% isolates in Tehran(Ghadiri et al, 2014). In this study, E. coli isolates exhibited variable rates of susceptibility and resistance to 10 different types of antibiotics.…”

“…In this study, E. coli isolates exhibited variable rates of susceptibility and resistance to 10 different types of antibiotics. The highest percentage of resistant to CEX (89.1%) and Jena et al, 2017), 7.37%(Yadav et al, 2015), 22% isolates of E. coli…”

Emerging Perils of Extended Spectrumβ-Lactamase Producing Enterobacteriaceae Clinical Isolates in a Teaching Hospital of Nepal

“…Chander and Shrestha from nearby hospital reported the ESBL prevalence rate to be 13.5% [18] whereas, recently, Neupane et al have reported 33.2% of ESBL producers in their study [19]. Similarly, Ansari et al [20], Khanal et al [21], Pokhrel et al [10], Yadav et al [22], and Pant et al [23] have reported 24%, 25%, 25.8%, 26.8%, and 31.3% ESBL producers, respectively. These findings correlated well with those of our study.…”