Study of Urinary Isolates With Reference to Extended Spectrum Beta Lactamases Detection and Antibiogram

Abstract

BACKGROUND:Extended spectrum beta lactamases continue to be major problem in clinical setups world over, conferring resistance to extended spectrum cephalosporins and are associated with significant morbidity and mortality. Urinary tract infections (UTIs) are one of the most common infectious diseases encountered in the clinical practice. Extended spectrum beta lactamases (ESBLs) production in gram negative bacteria, have emerged as a major problem in hospitalized as well as community based patients. ESBLs producing bacteria may not be detected by routine disc diffusion susceptibility test, leading to inappropriate use of antibiotics and treatment failure. The objective of this study was to determine the resistance patterns of the micro-organisms isolated from cases of UTI and to detect ESBLs production in gram negative bacteria. METHODS: Urinary isolates from symptomatic UTI cases (both in patients and out patients) attending the, Kesarsal Medical College and Hospital Ahmadabad were identified by conventional methods. Antimicrobial susceptibility testing was performed by Kirby Bauer's disc diffusion method gram negative isolates resistant to third generation cephalosporins were tested for ESBL production by two methods. RESULTS: Number of urinary isolates from patients with symptomatic UTI was 350 over a study period of one year. E.coli was the predominant isolate (57.7%) both in IPD and OPD patients. A total of 171 gram negative isolates resistant to third generation cephalosporins were tested for ESBL production by two methods-Modified Double Disc Synergy Test (CLSI) Phenotypic Confirmatory Test (PCT). ESBL production was seen in 36 (21.05%) isolates. Maximum ESBL production was seen in K. pneumoniae (22.41%) isolates followed by E.coli (13.26%). CONCLUSION: This study showed E.coli to be the predominant urinary pathogen isolated from UTI cases. Overall incidence of ESBL producing microorganisms was 21.05%.

Plasmid and Total Protein Analyses of Extended Spectrum Beta Lactamase Producing Bacteria from Periplaneta americana (Coackroaches)

“…A significant increase in the incidence of infections associated with extended-spectrum beta-lactamase (ESBL) producing organisms has been observed throughout the world (Gupta, 2007;Fatemeh et al, 2012;Abhijit et al, 2013;Majda et al, 2013;Meeta et al, 2013 andRupinder et al, 2013). These types of organisms have different alleles such as SHV-1 (named after the Sulfhydryl-variable active site), CTX-M (which preferentially hydrolyze cefotaxime over ceftazidime and also cefepime with high efficiency), TEM-1 (designated Temoniera) and blaCTX-M (which are well represented in many different genera of the family Enterobacteriaceae and Pseudomonas aeruginosa).…”

“…These organisms have universal dissemination and are readily recovered from various samples including both living (Fatemeh et al, 2012;Abhijit et al, 2013;Popoola et al,2019) and non-living samples (Thomas et al,2015). Their presence in almost every conceivable environment is well reported (Fatemeh et al, 2012;Abhijit et al, 2013;Popoola et al,2019), while some recovery from toilet seats, sinks and toilet environments have also been documented (Balogun et al, 2020).…”

Synergistic Role of Plant Extracts and Essential Oils against Multidrug Resistance and Gram-Negative Bacterial Strains Producing Extended-Spectrum β-Lactamases

“…Treatment against these multidrug-resistant bacteria is of profound scientific concern. Recent ongoing studies showed a substantial change in the cases of ESBL-related diseases notified across the world [ 3 ]. Recently, there has been a hypothetical move in the subtraction of probable antibacterials.…”