Comparison of Antibiotic Sensitivity between Extended Spectrum Beta Lactamase Producers and ESBL Negative Escherichia coli Clinical Isolates

Abstract


 Background: Recurrent urinary tract infection [UTI] and treatment failure were common challenges in the control of UTI in Iraqi community. 
 Objective: To determine the difference in antibiogram and multidrug resistance between ESBL positive and negative E. coli clinical isolates. 
 Materials and methods: prospective cross-sectional study was conducted during the period from 1st of June 2015 to the end of January 2016. The study population was 563 women, of them 425 [75.5%] were outpatients, and 138 [24.5%] were inpatients. Their age range was between 18 and 80 years, with a mean age of 33.59±15.29 years. Urine samples were immediately cultured on blood agar and MacConkey agar by spread plate technique. Bacterial colonies with different morphology were selected, purified and identified according to their biochemical characteristics using conventional standard methods. 
 Results: The rate of resistance was higher in ESBL positive as compared to ESBL negative producers E. coli isolates for all tested antibiotics. A high rate of resistance was demonstrated by most of the tested antibiotics. A low resistance rate in both ESBL positive and negative E. coli were demonstrated against amikacin, imipenem and nitrofurantoin. ESBL producer E. coli isolates were resistant to ≥5 of MDR in 98% of isolates [92/94], while the corresponding value was 71% [29/41], while MDR to ≥7 was 56% [53/94] in ESBL producer and 17% [7/41] in ESBL none producer E. coli. 
 Conclusion: ESBL producing was of significant influence on the emergence of resistance in E. coli clinical isolates