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. 2018 Mar-Apr;50(2):69-74.
doi: 10.4103/ijp.IJP_200_17.

Incidence of multidrug resistance and extended-spectrum beta-lactamase expression in community-acquired urinary tract infection among different age groups of patients

Sakina Fatima  1 , Iyad Neeam Muhammad  1 , Shahnaz Usman  2 , Subia Jamil  3 , Muhammad Naseem Khan  4 , Seema Ismat Khan  4
Affiliations

Incidence of multidrug resistance and extended-spectrum beta-lactamase expression in community-acquired urinary tract infection among different age groups of patients

Sakina Fatima et al. Indian J Pharmacol. 2018 Mar-Apr.

Abstract

Objectives: Urinary tract infection (UTI) is a frequent disorder and depends on age and gender. Ineffective empiric treatment of UTI is common when associated with extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae. The aim of the study was to investigate the prevalence of Gram-negative uropathogens of E. coli and K. pneumoniae in different age groups along with the identification of ESBL-producing uropathogens and antimicrobial susceptibility profiles.

Materials and methods: A total of 247 uropathogens of E. coli and K. pneumoniae were collected over a period of 1 year (January-December 2015) from various diagnostic centers of Karachi city (Pakistan). Antimicrobial susceptibility analysis was performed by disc diffusion method, and identification of ESBL was performed by double disc synergy test. Categorical data of ESBL and non-ESBL uropathogens were analyzed by Pearson's Chi-square test.

Results: The study of 247 patients with community-acquired UTI comprised 72% females and 28% males, illustrating an increased prevalence of UTIs among females. It was also revealed that 90% belonged to the age group of 16-30 years whereas 78% related to the age group of 46-60 years. ESBL was found positive in 33.5% (63/188) of E. coli and 15.25% (9/59) in K. pneumonia, with a significant association i.e., (p =0.007). Amikacin, fosfomycin, imipenem, and tazobactam/piperacillin were found to be the effective treatment options. A significant association was found between ESBL-producing uropathogens against ciprofloxacin, enoxacin, and amoxicillin/clavulanic acid resistance (P < 0.05).

Conclusions: It was concluded that for effective treatment of UTIs, appropriate screening of ESBL and culture sensitivity must be employed instead of empiric treatment.

Keywords: Empiric treatment; extended-spectrum beta-lactamase; multidrug resistance; urinary tract infections.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Distribution of uropathogens with gender in different age groups
Figure 2
Figure 2
Multidrug-resistant and extended-spectrum beta-lactamase-positive uropathogens in different age groups
Figure 3
Figure 3
Estimation of extended-spectrum beta-lactamase production by double disc synergy test
See this image and copyright information in PMC

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