Abstract
Introduction and Objectives: Urinary tract infections (UTIs) are frequent and predominantly caused by coliforms. ESBL producers are increasing in number limiting therapeutic options. It is therefore vital to institute precise, empiric antibiotic guidelines in order to prevent life-threatening urosepsis. The objective of this study was to compare antibiotic sensitivity (ABST) pattern of ESBL producers and non-ESBL producers against selected non-beta lactams and carbapenem antibiotics. Methodology: Retrospective analysis of ABST of significant urinary coliform isolates was done. Study setting: Department of Medical Microbiology, Faculty of Medicine, University of Kelaniya and Base Hospital, Wathupitiwala, Sri Lanka. Study period: 01.01.2012 - 01.01.2016. Study groups: ESBL producers and non-ESBL producers, 63 in each group. Sensitivity profiles of amikacin, gentamicin, netilmicin, nitrofurantoin, nalidixic acid, norfloxacin, ciprofloxacin, imipenem and meropenem were analyzed. Statistical analysis: R programming language. Level of significance P Results: ESBL producers were present in 63 patients, 36 (57.1%) of whom were females and 39 were inpatients (61.9%). Non-ESBL producers were isolated from urine of 63 patients, of whom 49 (77.8%) were females and 17 (26.9%) inpatients. Antibiotic sensitivity of ESBL producers ranged from 82.2% to 100% for netilmicin, amikacin, meropenem and imipenem, 65% for nitrofurantoin and from 14.8% to 32.1% for nalidixic acid, ciprofloxacin, norfloxacin and gentamicin. Antibiotic sensitivity of the non-ESBL producers ranged from 56.7% for nalidixic acid and from 76.8% to 85.1% for ciprofloxacin, nitrofurantoin, norfloxacin and gentamicin. Conclusion: A female predominance was noted in both non ESBL and ESBL producers but there was a significant dominance of ESBL producers in male patients. ESBL producers were significantly common amongst inpatients than outpatients. ESBL-producers had significantly high resistance against nalidixic acid, ciprofloxacin, norfloxacin and gentamicin compared to non-ESBL producers. However, more than 2/3rd of isolates in both groups were sensitive to nitrofurantoin.
Highlights
Introduction and ObjectivesUrinary tract infections (UTIs) are frequent and predominantly caused by coliforms
A female predominance was noted in both non extended spectrum beta lactamase (ESBL) and ESBL producers but there was a significant dominance of ESBL producers in male patients
ESBL producing coliforms were significantly lower than non-ESBL producers in the age group of < 20 years (P=0.01) compared with older patients (Table 1)
Summary
Introduction and ObjectivesUrinary tract infections (UTIs) are frequent and predominantly caused by coliforms. Along with increasing antibiotic resistance, extended spectrum beta lactamase (ESBL) producers have been increasing.[6,7] Gram-negative organisms, in particular, members of the Enterobacteriaceae family, e.g. E_coli and Klebsiella species, produce β-lactamases with an extended spectrum of activity.[8,9,10] ESBL producers are resistant to the penicillins including the first, second and third-generation cephalosporins and aztreonam but not to the cephamycins or carbapenems. Even though such organisms are known to occur in nosocomial settings, they have become a threat to the community as well. The increasing prevalence of ESBL strains has resulted in prolonged hospital stay, limited therapeutic options and treatment failures resulting in an increased mortality.[11]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
