Outcome of urinary tract infection caused by Extended Spectrum Beta-Lactamase (ESBL) producing Escherichia coli and Klebsiella pneumoniae in Dr Zainoel Abidin General Hospital Aceh

Abstract

Introduction : Extended-spectrum ?-lactamase (ESBL) is a mutated ?-lactamase enzyme that can hydrolyze beta-lactam antibiotics. The aim of this study was to determine the incidence rate, characteristics of patients, antibiotic use and outcome of urinary tract infections (UTIs) due to ESBL-producing Escherichia coli and Klebsiella pneumoniae at Dr Zainoel Abidin General Hospital Aceh.Method : The samples of this study were all Escherichia coli and Klebsiella pneumoniae isolated from urine culture of UTI cases. Patient characteristics and antibiotic use data were extracted from medical records. UTIs outcome was assessed as clinical improvement or death within a maximum of 30 days of treatment.Result : The results of this study obtained 63 patients with UTIs caused by E. coli and K. pneumonia of which 52.4% of them were ESBL producers. The incidence of UTIs due to E. coli was higher than that of K. pneumoniae, 63.5% and 36.5% respectively. E. coli ESBL producers were more in number than non-ESBL, conversely K. pneumoniae were mostly non-ESBL. The characteristics of patients with UTIs caused by E. coli and K. pneumoniae were predominant women 52.4%, and most cases were at 56-64 years old. Antibiotic therapy that given before and after culture results to UTI patients were generally ceftriaxone. UTIs outcome due to ESBL producing Escherichia coli and Klebsiella pneumoniae showed that 26/33 (78.8%) patients experienced improvement, however, 7/33 (21.2%) patients died.Conclusion : The irrational use of ceftriaxone in patients with UTI caused by ESBL producing E. coli and K. pneumoniae has led to a poor outcome for the patient.

Abundance and phenotypic-genotypic analysis of antibiotic-resistant Escherichia coli isolated from wastewater of the Zainoel Abidin Hospital, Banda Aceh, Indonesia

“…E. coli isolates in clinical samples at dr. Zainoel Abidin Hospital are almost entirely ESBL, which is 89% (Hayati et al 2019). Then, the number of E. coli that produce ESBL is more than other bacteria in urine samples (Hayati et al 2021). In addition, Hospital effluent is a major contributor to ESBL-EC in municipal wastewater (Bréchet et al 2014;Azuma et al 2022).…”

Phenotypic and Genotypic Characterization of Multidrug-resistant Escherichia coli and Klebsiella pneumoniae Isolated from Women with Urinary Tract Infections in Mosul City

“…Urinary tract infections (UTI) are a frequent in humans, especially in women [1], and represent about 25% of heath care infections that are mainly unresponsive to treatment with common antibiotics due development of antibiotic resistance [2]. Antibiotic resistance has increased the impact of UTIs treatment, especially ones with multi-drug resistance (MDR) features as a function of increase in the cost and length of treatments, in addition to the burden of the side effects of using several types of antibiotics [2,3]. Enterobacteriaceae is a principal pathogen of UTI.…”

“…Enterobacteriaceae is a principal pathogen of UTI. However, Escherichia coli and Klebsiella pneumoniae are the main members of Enterobacteriaceae that have been frequently isolated from women suffering urinary tract infections (UTI) [3,4]. On the other hand, spreading of resistant bacteria has become a global problem nowadays, especially those belonging to Enterobacteriaceae with multidrug-resistance (MDR) properties mainly against aminoglycosides, macrolides, quinolones, and sulphonamides classes [5,6].…”

Various types of extended spectrum β-lactamases: a literature review

“…This causes a high health burden in an infection due to the nature of resistance to many classes of antibiotics, referred to as multi-resistant (multidrug resistant). 2 One of the multi-resistance that often occurs is due to the Extended Spectrum β -Lactamase (ESBL) enzyme produced by bacteria, where this enzyme can hydrolyze β-lactam-type antibiotics thereby reducing their ability to work. 2 β-lactam antibiotics are the most common treatment used for bacterial infections, but they are also a major cause of resistance to β -lactam antibiotics among gram-negative bacteria worldwide.…”