National Academy of Agricultural Sciences (NAAS)
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PRINT ISSN : 2319-7692
Online ISSN : 2319-7706 Issues : 12 per year Publisher : Excellent Publishers Email : editorijcmas@gmail.com submit@ijcmas.com Editor-in-chief: Dr.M.Prakash Index Copernicus ICV 2018: 95.39 NAAS RATING 2020: 5.38 |
Urinary tract infections (UTIs) caused by Extended-Spectrum Beta-Lactamase (ESBL)-producing Escherichia coli represent a growing therapeutic challenge due to their multidrug-resistant nature. The rising prevalence of ESBL-producing uropathogens, particularly in developing countries, necessitates routine detection and updated antimicrobial surveillance. This study aimed to determine the prevalence of ESBL-producing E. coli among UTI patients and evaluate their antimicrobial resistance profile at a tertiary care centre in Bareilly, India. A retrospective study was conducted in the Department of Microbiology, SRMS Institute of Medical Sciences, over six months (November 2023 – May 2024). One hundred urine samples (midstream, catheter, and suprapubic aspirate) from clinically suspected UTI patients were processed. Semi-quantitative culture on CLED agar, biochemical identification, and VITEK-2 automated confirmation were performed. Antibiotic susceptibility testing followed the Kirby–Bauer disk diffusion method per CLSI 2023 guidelines. ESBL detection was confirmed phenotypically using the Double Disc Synergy Test (DDST). Culture positivity was 72%. Escherichia coli was the predominant isolate (63.9%), of which 45.7% were confirmed ESBL producers. ESBL-positive strains showed 100% resistance to third-generation cephalosporins (cefotaxime, ceftazidime, ceftriaxone), high resistance to fluoroquinolones (ciprofloxacin 81%, levofloxacin 76%) and cotrimoxazole (85%). Carbapenems (imipenem and meropenem) retained 100% sensitivity in both ESBL and non-ESBL groups. Female patients accounted for 62% of ESBL-positive cases. ESBL-producing E. coli constitutes a significant proportion of UTI isolates with extensive multidrug resistance. Carbapenems remain the most reliable therapeutic option. Routine ESBL screening, antimicrobial stewardship, and continuous resistance surveillance are essential to limit further spread of resistant strains.
Abdelgader, M.L., Aladeen, A.S.H., Mahjaf, G.M., Altaher, T.A. and Hamad, M.N.M. (2023) 'Detection of extended spectrum beta-lactamase among urinary tract infections in Khartoum State, Sudan', International Journal of Advanced Research in Biological Sciences, 3, p.123. ISSN: 2583-6439.
Aggarwal, R., Chaudhary, U. and Sikka, R. (2009) 'Detection of extended-spectrum β-lactamase production among uropathogens', Journal of Laboratory Physicians, 1(1), pp.7–10. https://doi.org/10.4103/0974-2727.54820
Al-Jamei, S.A., Albosoul, A.Y., Bakri, F.G. and Al-Bakri, A.G. (2019) 'ESBL-producing Escherichia coli in urinary tract infections: A two-center, cross-sectional study of prevalence, genotype and risk factors in Amman, Jordan', Jordan Journal of Pharmaceutical Sciences, 12(1), pp.21–25.
Clinical and Laboratory Standards Institute (2023) Performance Standards for Antimicrobial Susceptibility Testing. 30th edn. CLSI Supplement M100. Wayne, PA: Clinical and Laboratory Standards Institute.
Collee, J.G., Fraser, A.G., Marmion, B.P. and Simmons, A. (2006) Mackie and McCartney Practical Medical Microbiology. 14th edn. Edinburgh: Churchill Livingstone.
De, A. and Baveja, S. (2013) 'Antimicrobial resistance pattern of uropathogens in a tertiary care hospital in India', International Journal of Health Sciences and Research, 3(10), pp.55–62.
Ehsan, B., Haque, A., Qasim, M., Ali, A. and Sarwar, Y. (2023) 'High prevalence of extensively drug-resistant and ESBL-producing uropathogenic Escherichia coli isolated from Faisalabad, Pakistan', Brazilian Journal of Microbiology, 39, pp.1–13. https://doi.org/10.1007/s42770-023-00934-4
Ejaz, H., Zafar, A., Ikram-ul-Haq and Mahmood, S. (2011) 'Urinary tract infection caused by extended spectrum beta-lactamase enzyme producing Escherichia coli', Pakistan Journal of Zoology, 10, p.16666. ISSN: 1560-8530.
Fitriawati, I., Wahyunitisari, M.R., Prasetyo, R.V., Puspitasari, D. and Jearaniwitayakul, T. (2021) 'The characteristics of children with urinary tract infection due to ESBL-producing bacteria at Dr. Soetomo General Academic Hospital, Surabaya', Biomolecular and Health Science Journal, 4, pp.38–41. https://doi.org/10.20473/bhsj.v4i1.26071
Foxman, B. (2002) 'Epidemiology of urinary tract infections: incidence, morbidity, and economic costs', American Journal of Medicine, 113(Suppl 1A), pp.5S–13S. https://doi.org/10.1016/S0002-9343(02)01054-9
Gupta, S., Kapur, S. and Padmavathi, D.V. (2014) 'Comparative prevalence of antimicrobial resistance in community-acquired urinary tract infection cases from representative states of northern and southern India', Journal of Clinical and Diagnostic Research, 8(9), pp.DC09–DC12. https://doi.org/10.7860/JCDR/2014/9679.4875
Harwalkar, A., Sataraddi, J., Gupta, S., Yogamand, R., Rao, A. and Srinivasa, H. (2013) 'The detection of ESBL-producing Escherichia coli in patients with symptomatic urinary tract infection using different diffusion methods in a rural setting', Journal of Infection and Public Health, 6(2), pp.108–114. https://doi.org/10.1016/j.jiph.2012.11.005
Kayastha, K., Dhungel, B., Karki, S., Adhikari, B., Banjara, M.R., Rijal, K.R. and Ghimire, P. (2020) 'Extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella species in pediatric patients visiting International Friendship Children's Hospital, Kathmandu, Nepal', Infection and Drug Resistance, 13, pp.1089–1095. https://doi.org/10.2147/IDR.S249578
Kothari, A. and Sagar, V. (2008) 'Antibiotic resistance in pathogens causing community-acquired urinary tract infections in India: a multicenter study', Journal of Infection in Developing Countries, 2(5), pp.354–358. https://doi.org/10.3855/jidc.218
Lakshminarayana, S.A. and Sangeetha, S. (2015) 'Detection of ESBL-producing gram-negative uropathogens and their antibiotic resistance pattern from a tertiary care centre', International Journal of Current Microbiology and Applied Sciences, 4(5), pp.578–583.
Livermore, D.M. (2008) 'Defining an extended-spectrum β-lactamase', Clinical Microbiology and Infection, 14(Suppl 1), pp.3–10. https://doi.org/10.1111/j.1469-0691.2007.01857.x
Manchanda, V. and Singh, N.P. (2003) 'Occurrence and detection of AmpC β-lactamases among Gram-negative clinical isolates using a modified three-dimensional test at Guru Tegh Bahadur Hospital, Delhi, India', Journal of Antimicrobial Chemotherapy, 51(2), pp.415–418. https://doi.org/10.1093/jac/dkg098
Nandi, S., Kumar, D.B., Pathak, S.S., Kumar, T.S., Pathak, A., Devnil, Mousumi, M.N., Mitra, P.S., Sasumal and Bhattacharya, B. (2022) 'Detection of ESBL Escherichia coli in urinary tract infection due to long-term catheterized conditions in COVID-positive patients admitted in ICU', International Journal of Current Research and Review, 8, pp.237–241. https://doi.org/10.31782/IJCRR.2022.81439
Nasiru, U., Naimat, D., Sherifat, O., Salami, T. and Iorzua, D. (2020) 'Detection of extended-spectrum beta-lactamase producing Escherichia coli from urinary tract infection in a general hospital', African Journal of Clinical and Experimental Microbiology, 21(4), pp.613–619. https://doi.org/10.4314/ajcem.v21i4.14
Paterson, D.L. and Bonomo, R.A. (2005) 'Extended-spectrum β-lactamases: a clinical update', Clinical Microbiology Reviews, 18(4), pp.657–686. https://doi.org/10.1128/CMR.18.4.657-686.2005
Pfaller, M.A. and Segreti, J. (2006) 'Overview of the epidemiological profile and laboratory detection of extended-spectrum β-lactamases', Clinical Infectious Diseases, 42(Suppl 4), pp.S153–S163. https://doi.org/10.1086/500663
Taneja, N., Rao, P., Arora, J. and Dogra, A. (2008) 'Occurrence of ESBL and Amp-C β-lactamases and susceptibility to newer antimicrobial agents in complicated urinary tract infection', Indian Journal of Medical Research, 127(1), pp.85–88.
Vincent, J.L., Rello, J., Marshall, J., Silva, E., Anzueto, A., Martin, C.D. et al., (2009) 'International study of the prevalence and outcomes of infection in intensive care units', JAMA, 302(21), pp.2323–2329. https://doi.org/10.1001/jama.2009.1754
Willacy, H. and Tidy, C. (2015) Extended-spectrum beta-lactamases. Patient.info. Available at: https://patient.info/doctor/extended-spectrum-beta-lactamases (Accessed: 12 November 2015).
Yadav, R.R. and Chauhan, B.P. (2016a) 'Detection of extended spectrum beta-lactamase producing Escherichia coli isolated from clinical samples by using Double Disk Synergy Test (DDST)', International Journal of Health Sciences and Research, 3, Gujarat, India. ISSN: 2348-8069.
Yadav, R.R. and Chauhan, B.P. (2016b) 'Detection of extended spectrum beta-lactamase producing Escherichia coli isolated from clinical samples by using phenotypic confirmatory test, Double Disc Diffusion Test (DDDT)', International Journal of Health Sciences and Research, 3, Gujarat, India. ISSN: 2348-8069.
Yoshimura, J., Yamakawa, K., Umemura, Y., Ooi, Y. and Fujimi, S. (2021) 'Impact of beta-lactamase detection reagent on rapid diagnosis of ESBL-producing pathogens using urine samples of patients with gram-negative bacteriuria', Journal of Infection and Chemotherapy, 113, pp.18–22. https://doi.org/10.1016/j.jiac.2020.10.009|
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