Detection of ESBL Producing Bacteria in Cases of Urinary Tract Infection in Pediatric Department at Benha University Hospital

Abstract

Background: Extended-spectrum beta-lactamases (ESBLs) are rapidly evolving group of beta-lactamase enzymes commonly produced by the Gram negative bacteria. Objectives: This work aimed to detect the bacterial pathogens that cause urinary tract infection and to detect ESBL producing bacteria among them in Pediatric Department at Benha University Hospital. Methodology: This study was conducted on 118 children patients suffering from UTI collected from Outpatient and Inpatient of pediatric department at Benha University during the period from January 2015 to the end of July 2015. They were 77 girls and 41 boys and their ages ranged from 1 to 13 years.118 Urine samples were subjected to isolation and identification of causative organisms, screened for ESBL production by the pattern of antimicrobial susceptibilities. Phenotypic identification for ESBL production was confirmed by double disc diffusion test, bla SHV and bla CTX-M genes in ESBL, producing isolates were detected by using multiplex PCR. Results: This study showed that the most common cause of children UTI was E.coli (55.1%) followed by klebsiella pneumoniae (21.2%). Thirty seven (31.4%) of 118 bacterial isolates that tested by double disc confirmatory test were ESBL positive. Among the ESBL producing bacteria, 16 out of 37 (43.24%) have CTX-m and SHV genes together while 3 out of 37 (8.1%) have SHV gene only. Conclusion: Our findings showed that majority of ESBL isolates were positive for both CTXm and SHV genes (43.24%) but SHV gene alone was positive only in (8.1%) of isolates, So studies should be done in different regions of Egypt to find the common ESBL genes present in that geographical area for epidemiological purposes. Also ESBL producing isolates have been increasingly recognized in hospitals in Egypt and are associated with multiple drug resistance. Thus, ESBL producing organisms should be identified quickly so that appropriate antibiotic usage and infection control measures can be implemented.

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“…E. coli outbreak with 13%, was reported the most common urinary germ and in the next ranks were Klebsiella (13%) and Entero bacter (06%) that were similar to most other studies [15][16][17] . 32% of children had abnormal ultrasound.…”

Molecular Characterization of Extended-Spectrum β-Lactamase Enterobacteriaceae Isolated from Egyptian Patients with Community- and Hospital-Acquired Urinary Tract Infection

“…at 23.3% and 21.2%, respectively. 11,12 The results of the antimicrobial resistance testing in the current study were very concerning; no significant difference was obtained in the antimicrobial susceptibility pattern of community-and hospital-acquired ESβL UTIs. We observed a high susceptibility of the ESβL-UTI isolates to carbapenems.…”

“…This was in agreement with several studies conducted on Egyptian patients in which a high prevalence of ESβL-induced UTI was detected at many hospitals in Egypt: Al-Azhar, Tanata, and the pediatric department at Benha University public hospitals (42.7%, 32.6%, and 31.4%, respectively). 11,12,25 Moreover, a higher rate (60%) of ESβL UTI was detected in Assiut University Hospital in Egypt. 26 In contrast to our study, a lower ESβL UTI prevalence was detected in other studies, in Dar es Salaam hospital, Tanzania (over 6 months period), and Marrakech University Hospital, Morocco (27% and 4.5%, respectively), between 2010 and 2012.…”

“…Escherichia coli and Klebsiella pneumoniae are the most predominant ESβL Enterobacteriaceae in the clinical setting; this has contributed to their beneficial value in estimating the prevalence of ESβL producers among different infections. [10][11][12] Although TEM and SHV are the most common ESβL genotypes, it has been reported that beta-lactamase (bla)cefotaxime (CTX)-M is the most prevalent ESβL in UTIs worldwide. 10,[13][14][15] Presently, CTX-M-15 is the most widely disseminated genotype.…”

Extended Spectrum Beta-Lactamase (ESBL) producing Escherichia coli and Klebsiella species in pediatric patients visiting International Friendship Children's Hospital, Kathmandu, Nepal

“…The collected samples were labeled properly and were immediately delivered to a laboratory for further processing. When immediate delivery was not possible, the specimens were refrigerated at 4-6°C [25].…”