Frequency of Extend Spectrum Beta Lactamase in Multiresistance Escherichia Coli and Klebsiella Pneumonia Isolated From Kidney Transplantation Patients

Abstract

In transplant recipients, infections are fatal and they can cause considerable morbidity due to constant changes of infection patterns, evolving donor-recipient characteristics, surgical techniques and immunosuppression regimens. The prevalence of resistance to antibiotics among bacteria causes infection in kidney transplant patients (KTPs). This type of infection is caused by a widespread use of antibiotics to prevent and treat infection in those patients. Objectives: The aim of the present study was to determine the incidence of urinary track infections (UTIs) among renal transplant recipients. The study also investigates the antimicrobial susceptibility pattern of causative agents. Materials and Methods: In this study, 200 samples of wound and urine were collected from patients admitted to Zheen international hospital in Erbil city in one year (January of 2019 to January of 2020). Two isolated gram negative (GN) strains were identified by using cultural, morphological, characteristics, and biochemical tests and Vitek 2 system. Results: From the 200 samples, 9 (4.5%) E.coli and K.pneumonia bacteria isolates were taken. Out of 9 (4.5%) of isolates, 4 isolated E.coli species were equal in males and females 4 (44.4%). K.pneumonia was 1 (11.1%) in females, and there was no isolation in males. Our results showed that urine was the major source of bacterial isolates collected comprising 6 were positive. E.coli 5(55.6%) for K. pneumoniae was 1(11.1%), while for wound swab was 3 samples E.coli 3(33.3%) and no K.pneumonia. Our results showed that most isolates of E.coli and K.pneumoniae were highly resistant against the majority of antibiotics, Escherichia coli and K. pneumonia showed 100% resistance against Ampicillin, Amoxicillin and Cloxacillin. The percentage of the resistance of E. coli to Trimethoprim/ Sulfamethoxazole, Azithromycin was high (88.9%). Also, sensitivity was as follows, Amikacin (88.89%), Ertapenem (88.89%), Gentamycin (77.78%), Meropenem (88.89%), Imipenem (88.89%), Tazobactam (77.78%). Extendedspectrum beta-lactamase ESBL production was very common among Ecoli, where out of the 8 (88.9%) E.coli isolates, 4 (44.4%) were producers of ESBL. However, K.pneumonia isolates were not. Conclusions: ESBL producing bacteria increase the rate of morbidity and mortality. This increase entails high healthcare costs. Also, MDR pathogens caused infections are a therapeutic challenge for clinicians and a risk for immuno-compromised patients. There are some antibiotics for the treatment of these infections. These antibiotics can be recommended mostly for non-oral means of administration but have higher risks of side effects.

Acute Kidney Injury is A Risk Factor among Type 2 Diabetic Patients after UTI due to Extended-Spectrum Beta-Lactamase Producing Organisms

“…Previous CKD and AKI positive history are risk factors for acute kidney injury 11 . Urinary tract infection in AKI can make things difficult [12][13] . Age, diabetes, subterranean kidney disease, upper UTI are risk factors for the UTI.…”