The Prevalence of Multidrug-Resistant Escherichia coli Producing ESBL among Male and Female Patients with Urinary Tract Infections in Riyadh Region, Saudi Arabia

Abstract

The Escherichia coli that produces extended-spectrum lactamases (ESBL-E. coli) can develop resistance to many antibiotics. The control of ESBL-E. coli disorders is challenging due to their restricted therapeutic approaches, so this study aims to determine the prevalence and pattern of the antibiotic resistance of ESBL-E. coli among male and female patients with urinary tract infections in Riyadh, Saudi Arabia. During the period of 2019 to 2020 at King Fahd Medical City, Riyadh, 2250 urine samples from patients with urinary tract infections (UTIs) were collected, and microbial species were cultured and identified using standard biochemical techniques. A double-disc synergy test was used to identify ESBL-producing strains of E. coli, and an in vitro method and the clinical laboratory standard institute (CLSI) criteria were employed to determine the resistance of these strains to antimicrobial drugs. ESBL-E. coli was detected in 510 (33.49%) of the 1523 E. coli isolates, 67.27% of which were recovered from women and 33.7% of which were recovered from men. A total of 284 (55.69%) ESBL-E. coli isolates were found in patients under 50 years of age, and 226 (44.31%) were found in patients over 50 years of age. Nearly all the isolates of ESBL-E. coli were resistant to cephalosporins (ceftriaxone, cefotaxime, cefepime, cefuroxime, and cephalothin) and penicillin (ampicillin), whereas the majority of the isolates were sensitive to several carbapenems (imipenem, meropenem, and ertapenem), aminoglycosides (amikacin), and nitrofurantoins. The development of antibiotic resistance by ESBL-E. coli, the most frequent pathogen linked to urinary tract infections, plays a crucial role in determining which antibiotic therapy is appropriate.

Phenotypic Characterization and Antibiograms of Extended-Spectrum Beta-Lactamase-Producing Escherichia coli Isolated at the Human-Animal-Environment Interface Using a One Health Approach Among Households in Wakiso District, Uganda

“…Carbapenems have also been reported in several other studies to still be effective on ESBL-producing organisms. 34 , 35 A study conducted in rural Tanzania among scavenging local chickens also revealed that the ESBL-EC isolates were 100% susceptible to Carbapenems and gentamicin. 36 Presentation of carbapenem resistance in our study could potentially be linked to exposures from hospital settings where significant resistance to this class of antibiotics has been reported.…”

Antibiogram And Prevalence Of ESBL Genes In Escherichia Coli From Clinical Specimen

“…Extended-spectrum-lactamases (ESBLs) have played a major role in the clinical area in recent decades in the wide-ranging and complicated world of -lactamases (17). Their significance stems from the fact that they greatly broaden the -lactamase range to encompass hydrolysis of all penicillins, cephalosporins (excluding cephamycins), and aztreonam.…”

Urinary Tract Infections in the Kingdom of Saudi Arabia, a Review

“…Thirteen articles were found that mentioned and tested ESBL-producing uropathogens. They were detected in approximately 2% [39], 7% [32], 8% [26], 9% [16], 11% [41], 12% [17], 15% [13], 17% [64], 20% [38], 45% [37], 33% [68], 43.5% [23], and 44% [51] of urinary specimens. ESBL species have been a major concern for healthcare systems all around the world since 2000 when their outbreak started [16,68].…”