The distribution and characteristics of Extended-Spectrum β-Lactamase producing Escherichia coli and Klebsiella species among urinary isolates in a tertiary care hospital

Abstract

A prospective study was carried out to determine the distribution of ESBL producing uropathogens in different units of a tertiary care hospital in Colombo and in community acquired UTIs presenting to this hospital. A total of 2303 urine samples from adult patients were received in the microbiology laboratory of the hospital during a four-month period, of which 626 were significant positive cultures. Escherichia coli and Klebsiella species accounted for 46% (n=286) of the total isolates with the majority (n=228, 80%) being E. coli. Thirty three percent (n=94) of these isolates produced extended-spectrum β-lactamases (ESBLs). Half (50%) of the Klebsiella isolates were ESBL producers while 29% of the E. coli produced ESBLs. Ten of 11 isolates in the intensive care unit and 6 of 8 in the genito-urinary unit were ESBL producers. The ESBL rate in the general medical and surgical wards and the out-patient department were 33% and 14% respectively. Out of the 181 isolates from community acquired UTIs, 13% produced ESBLs. Resistance to multiple drugs was considerably higher in ESBL positives compared to ESBL negative isolates. Urinary catheters, diabetes mellitus, previous antibiotic use, urinary tract abnormalities and recurrent urinary tract infections were associated with a higher risk of acquiring ESBL producing organisms (P<0.001).

Prevalence, antibiotic sensitivity pattern and genetic analysis of extended spectrum beta lactamase producing Escherichia coli and Klebsiella spp among patients with community acquired urinary tract infection in Galle district, Sri Lanka

“…Majority of culture positive patients were females (57.86%). These facts are compatible with most of previous CA-UTI studies [4].…”

“…In this community, ESBL producing Escherichia coli and Klebsiella pneumoniae prevalence was 40.44% while Mohomed et al in India [8] found almost same in 2007. However, according to the local study done by Dissanayake et al in 2010 [4], the ESBL prevalence found among the CA-UTI patients was 13%.…”

“…Sample size was calculated as 173 according to the study by Dissanayake et al, (2010) [4] in which the ESBL prevalence among CA-UTI patients was 13%. For the calculation the standard formula n=Z 2 pq/d 2 was used with margin of error (d) of 5%.…”

Resistance and utilisation pattern of antibacterial agents in outpatient settings in two Teaching Hospitals in Colombo

“…The rate of ESBL producing E. coli in our study is similar to that among out patients in a tertiary care setting [20]. Previously ESBL producing E.coli was shown to be a problem in the hospital settings only, however the problem has been reported to be extending to community settings Paper as well [21].…”

Antibiotic sensitivity pattern for non-beta lactam antibiotics and carbapenems in extended-spectrum beta-lactamase (ESBL) producing uropathogens versus non-ESBL producing uropathogens

“…Similar patterns of ABS has been detected in a previously conducted local study. 22 This difference is not statistically significant, but needs further study with a larger sample size and evaluation of MIC values.…”