Prevalence and antibiogram of ESBL producing gram negative bacilli isolated from urine in Dhaka Medical College Hospital, Bangladesh

Abstract

Extended spectrum ß-lactamase (ESBL) producing strains are resistant to a wide variety of common antimicrobials and become a major clinical concern worldwide that has complicated treatment strategies. The current study has been carried out to detect ESBL producing gram negative bacilli with their antimicrobial susceptibility pattern from urine collected over a period of 12 months from July 2011 to June 2012 from Dhaka Medical College Hospital. Samples were cultured in blood agar and MacConkey's agar media and organisms were identified by different biochemical tests such as oxidase test, reaction in MIU and simmon's citrate media and different sugar fermentation tests. ESBL producers were detected by double-disk synergy test (DDST). From total of 300 urine samples, 157 (52.33%) gram negative bacilli causing UTI were isolated and most of them were Escherichia coli (71.34%) followed by Enterobacter aerogenes (13.38%). Among the isolates, 45 (28.66%) ESBL producers were detected. The highest of ESBL producer was observed in Escherichia coli (32.14%) followed by Klebsiella pneumoniae (28.57%), Enterobacter aerogenes (23.80%) and Acinetobacter spp (20%). ESBL producers were significantly more resistant to ciprofloxacin, gentamycin, doxycycline, amoxiclav and co-trimoxazole than non-ESBL producers. All the ESBL producing strains were sensitive to imipenem. The result of this study provides insight into the high proportion of highly resistant ESBL producing organisms and more effective strategies are needed to control the spread of these resistant organisms.

Molecular Characterization of Extended-Spectrum Beta-Lactamase Producing Urinary Escherichia coli Isolated in Brong-Ahafo Regional Hospital, Ghana

“…ESBLs are not just nosocomial infections in big hospitals in Ghana, but are spreading into the communities as well (Feglo et al, 2013). In this present study 43/51(84%) of the urinary E. coli isolates produced ESBL and 16(37.2%) were community isolates, an observation, which confirms findings in other studies that ESBL-producing Enterobacteria are detectable in both community and hospitalized patients with varying prevalence levels as 63% was reported from Mali (Tande et al, 2009), 43% in Ghana (Feglo et al, 2013), 40% in Niger (Woerther et al, 2011) and 26% in Kenya (Kariuki et al, 2007) and 28.66% in Bangladesh (Islam et al, 2017). It was estimated that ESBL prevalence of 80% in a hospital setting will lead to as much as 80% of treatments failures and 35% Bla CTX-M bands (593pbs) mortality (Perez et al, 2007).…”

Prevalence and Antibiogram of Extended-Spectrum Beta-Lactamase Producing Gram-negative Bacteria Isolated from Septicemic Neonates in a Tertiary Care Hospital

“…8 The prevalence of ESBL producers is increasing in Bangladesh which is reflected by several studies conducted in DMCH irrespective of age and different samples. ESBL producing organisms detected among Gram-negative bacteria from various samples were 29% in 2011 by Islam et al 9 , 25% in 2012 by Farzana et al8 and 33% in 2015 by Shamsuzzaman. 23 Enterobacter spp.…”

“…However, several studies reported E. coli as most commonly isolated ESBL producers from different clinical samples in Bangladesh. 8,9,25 The disparity of the isolation rate of different ESBL producers may be due to varying prevalence of infection causing bacteria from one area to area and hospital to hospital. Different hospital deals with different types of disease and different protocol of antibiotic usage.…”

Isolation and Identification of Multi-Drug Resistant Acinetobacter baumannii from a tertiary health care centre of Bangladesh

“…Several studies reported recognizing different health care facilities in Bangladesh as breeding grounds of pathogenic A. baumannii [21,22]. Several authors of Bangladesh cited about the recovery of MDRAB strains from clinical samples from Bangladesh [18][19][20][21][22].…”

“…Different researches have been conducted about A. baumannii infections and its resistance to different antimicrobials. Recovery of MDRAB isolates from different clinical samples has been reported in several reports in Bangladesh [18][19][20][21][22]. In a study conducted at the Dhaka Medical College Hospital (DMCH) reported by Khatun [21], 25 A. baumannii isolates were recovered from endotracheal aspirate samples of patients admitted to the ICU of DMCH.…”