Abstract
Background: Antibiotic resistance is a challenge to treat. Extended Spectrum Beta Lactamases (ESBL) is one of the phenomenon by which the uropathogen express resistance to the commonly used antibiotic. Objectives: To determine the frequency of ESBL in uro-pathogens and ESBL preference for age and gender. Methods: This cross sectional study was conducted in Qazi Hussain Ahmed Medical Complex Nowshera from 1stMar 2019 to 31st Jan 2020. A total of 315 urine samples were received for Culture and sensitivity out of which 77 cases reported to be ESBL positive (24.44%).Relevant information’s were recorded in SPSS version 25. Results: A total of 77 cases with established ESBL phenomenon were studied. 40% were males and 60% females. The frequency of ESBL positive isolates was (24.44%). In 71(92%) cases of ESBL , Escherichia coli strain was reported, Klebsiella pneumonia in 5(6.5%) and Proteus mirabilis in 1.3% cases. The difference in Means +SD of age of the male gender (24.25years+9.6) was statistically significant with female gender(31.16years+14.49) (p-value 0.02). The probability of ESBL infections was 2.16 times higher in female gender (p-value: 0.01, OR:2.16). The sensitivity pattern of the ESBL producing E. coli was; Imipenem(IMP) 100%, Meropenem(Mem)100%, Piperacillin Tazobactam(TZP) 92%, Nitrofurantoin (F)-85% . While Imipenem & meropenem were drugs of choice for ESBL-Klebsiella pneumonia and ESBL -Proteus mirabilis. Conclusion: The frequency of ESBL isolates was 24.44%. Female gender reported more ESBL infection as compared to male gender. Escherichia coli ESBL was most common. The common sensitivity pattern to ESBL was: Imipenem(IMP) 100%, Meropenem(Mem)100% and Piperacillin Tazobactam 95%.
Highlights
Treating uropathogenic Escherichia coli (UPEC) is a challenge for the doctors of the present era
Fourty percent were males and 60% females with male to female ratio of 1:1.5 In 92% cases Extended Spectrum Beta Lactamases (ESBL) phenomenon was observed in the Escherichia coli, 6.5% in Klebsiella ESBL and 1.3% in Proteus mirabilis (Table 2)
The prevalence of the ESBL – Escherichia coli was higher as compared to other types of uropathogens
Summary
Treating uropathogenic Escherichia coli (UPEC) is a challenge for the doctors of the present era. Extended spectrum beta lactamases, called CTX-M (i.e., “active on CefoTaXime, first isolated in Munich”), has been reported in 2000 is major type prevalent worldwide for causing ESBL types of infections [2]. Extended Spectrum Beta Lactamases (ESBL) is one of the phenomenon by which the uropathogen express resistance to the commonly used antibiotic. In 71(92%) cases of ESBL, Escherichia coli strain was reported, Klebsiella pneumonia in 5(6.5%) and Proteus mirabilis in 1.3% cases. The sensitivity pattern of the ESBL producing Escherichia coli was; Imipenem(IMP) 100%, meropenem (Mem)100%, piperacillin tazobactam (TZP) 92%, nitrofurantoin (F)-85%. Female gender reported more ESBL infection as compared to male gender. The common sensitivity pattern to ESBL was: Imipenem(IMP) 100%, meropenem (Mem)100% and piperacillin tazobactam 95%
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