Abstract
Escherichia coli is a Gram-negative bacterium from Enterobacteriaceae family causes urinary tract infections (UTI). A major problem encountered in antibiotics therapy is Multiple Drug Resistant Organisms (MDROs). MDROs occur because of the presence of resistance coding genes such as CTX-M which causes bacteria to produce the Extended Spectrum Beta-Lactamase (ESBL) enzyme. This study aims to detect the presence of the CTX-M gene in Extended-Spectrum Beta Lactamase (ESBL) Escherichia coli isolated from UTI patients. The study was conducted at the Institute of Tropical Disease (ITD) Airlangga University, Jl. Mulyorejo Campus C Surabaya, Indonesia for polymerase chain reaction (PCR) examination. The isolation and identification of Escherichia coli bacteria were carried out at the Microbiology Laboratory Department in Poltekkes Kemenkes Surabaya, Jl. Karangmenjangan 18A, Surabaya, Indonesia. Conventional identification of Escherichia coli and the presence of the CTX-M gene were observed using the PCR method. The results showed that 18 of 30 samples (60%) were caused by Escherichia coli. Escherichia coli producing ESBL was found in 15 samples (83%), of which 12 samples (80%) showed the presence of the CTX-M gene.
 Keywords : CTX-M gene, Extended-Spectrum Beta Lactamase (ESBL), Escherichia coli
Highlights
Urinary tract infection (UTI) is an infection caused by microorganisms in the urinary tract, which starts from infection in urinary tract, genital organs, until kidneys
According to the study conducted in early August 2020 at the Microbiology Laboratory in RSUD Dr Soetomo Surabaya, the following results are obtained from urine sample of patients with UTI after identification and isolation had been performed: sample of Pseudomonas aeruginosa; 2 samples of Eschericchia coli; 1 sample of Corinebacterium; 1 sample of Candida tropicalis, and in 5 sterile samples
Negative cultures that did not produce Extended-Spectrum Beta Lactamase (ESBL) were found in 1 sample of Enterobacter cloaceae; 2 samples of Klebsiella pneumoniae; 1 sample of Proteus mirabilis; 1 sample of Pseudomonas aeruginosa; 2 samples of Escherichia coli; 1 sample of Corinebacterium; 1 sample of Candida tropicalis; and sterile
Summary
Urinary tract infection (UTI) is an infection caused by microorganisms in the urinary tract, which starts from infection in urinary tract, genital organs, until kidneys. UTI is the second most common infectious disease after respiratory tract infection, with 8.3 million cases reported every year. According to data from the Ministry of Health of the Republic of Indonesia, the number of UTI patients in Indonesia is 90-100 cases per 100,000 population per year or around 180,000 new cases per year. The World Health Organization (WHO) defines antibiotic resistance as the process of mutation in microorganisms exposed to antibiotic drugs, thereby making the infection last and increasing the risk of spreading the disease to others (WHO, 2015). Antibiotic resistance often results in failure to treat the disease, resulting in disability and even death. If a patient is already resistant to antibiotics, various medical procedures such as organ transplants, chemotherapy, diabetes treatment, and major surgery become very risky. Patients have to endure longer and more expensive treatments (RI Ministry of Health, 2018)
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