Prevalence and antibiotic resistance pattern of extended spectrum beta lactamase producing Escherichia coli isolated from urinary tract infection

Abstract

Introduction: Urinary tract infection (UTI) due to extended spectrum beta-lactamase (ESBL)-producing bacteria including Escherichia coli has become widespread. Studies have shown a trend toward higher mortality, longer hospitalization, greater hospital expenses and reduced rates of clinical and microbiologic response in ESBL UTI. Objectives: The aim of this study is to determinate the prevalence and antibiotic resistance pattern of ESBL producing E. coli isolated from UTI. Patients and Methods: This cross-sectional study was conducted on 3126 samples. Urine specimens were cultured on Eosin Methylene Blue (EBM) and blood agar. The disk diffusion standard method (Kirby Bauer) was used to test the susceptibility of the drug on MullerHinton agar plates and results were reviewed based on Clinical and Laboratory Standards Institute (CLSI) criteria. The reviewing of ESBL-producing uropathogens was carried out using Combined Disk Test (CDT) by using cefotaxime (CTX; 30 µg) and cefotaximeclavulanic acid (CTX; 30 µg /CA:10 µg) disks and CLSI protocol. Results: Out of 291 E. coli isolates, 108 (37.11%) are ESBL-producer and 183 (62.89%) are non–ESBL-producer. Among ESBL-producing E. coli, the highest antibiotic resistance was observed with cefotaxime (100%), amoxicillin (97.22%) and piperacillin (96.3%) and the highest antibiotic sensitivity was observed with meropenem (93.5%), nitrofurantoin (81.48%) and gentamicin (55.56%). Conclusion: We recommended that cephalosporins, penicillins and cotrimoxazole are not suggested in the treatment of ESBL-producing E. coli. On the other hand, carbapenems as a first line and aminoglycosides as the next step in the treatment of ESBL-producing E. coli are recommended.

Evaluating the antimicrobial resistance patterns and MDR frequency in Escherichia coli strains isolated from clinical specimens taken from patients in Iran: 2017–2019

“…Due to the weakened immune system of burn patients, broad-spectrum antibiotics are used to treat bacterial infections in this group, which may increase the prevalence of antibiotic resistance (20). With the exception of carbapenems, the above results are consistent with other Iranian studies conducted in 2019 (21,22). The antibiotic resistance rate of E. coli strains in Turkey was also much lower than in the present study (20).…”

“…These results indicate that unlike amikacin, ampicillin is not suitable for the treatment of E. coli infections in Iran. Moreover, resistance to carbapenems among isolates collected from Bu-Ali Sina hospital in this study was similar to other studies in Iran and neighboring countries (13,19,21,22,25), while the reported carbapenem resistance rates in non-neighboring countries such as Malaysia and Nigeria were 29.2% and 19.7%, respectively (26,27). This discrepancies may be due to the differences in the type of sample, as Bu-Ali Sina hospital is a specialized pediatric hospital.…”

Antibiotic Resistance Pattern of Extended Spectrum Beta Lactamase Producing Escherichia coli Isolated From Patients With Urinary Tract Infection in Morocco

“…The first bacteria expressing acquired ESBL were identified in 1983 in Germany, and since 2000, ESBL-producing Escherichia coli (ESBL-EC) have spread throughout the world in both community and hospital settings (Kruglova & Stasheva, 2010;Rossignol et al, 2017;Rajabnia et al, 2019). Worryingly, the incidence of ESBL-EC continues to increase worldwide (Khanfar et al, 2009;Shakya et al, 2017).…”

“…β-Lactam antibiotics are the safest and most frequently prescribed antimicrobial agents for urinary tract infection (UTI) ( Magale et al., 2016 ). They are a class of broad-spectrum antibiotics that contain a beta-lactam ring in their molecular structure ( Ahmed et al., 2015 ; Rajabnia et al., 2019 ). Several studies prove the increased resistance of E. coli in UTI to beta-lactam antibiotics ( Glasner et al., 2013 ; Tacconelli et al., 2018 ).…”

“…Several studies prove the increased resistance of E. coli in UTI to beta-lactam antibiotics ( Glasner et al., 2013 ; Tacconelli et al., 2018 ). Another worry is the “emergence of extended spectrum Beta-Lactamase (ESBL) producing bacteria” that hydrolyze beta-lactam ring, inactivate the antibiotic, and reduce consequently the number of treatment options ( Ruano-de-pablo & Losada-pinedo, 2016 ; Rajabnia et al., 2019 ).…”