EXTENDED-SPECTRUM β-LACTAMASE PRODUCING ESCHERICHIA COLI AND KLEBSIELLA PNEUMONIAE IN URINARY TRACT INFECTIONS

Bacterial species were isolated from clinical urinary specimens from hospitalized patients by urinary tract infections using standard microbiological procedures. The identification to the species level and antimicrobial susceptibility test has been carried out by automated method with Vitek 2 system (bioMerieux, Marcy L’Etolile, France). Production of ESBL activity was confirmed in screening-positive isolates via a double-disk synergy test. CTX-M type ESBLs was screened in isolates of E. coli and Klebsiella pneumoniae. The results showed that the prevalence of ESBL producers was very high up to 70% (49 of 70) among E. coli isolates and 68.8% (11 of 16) among K. pneumoniae. Resistance rates of E. coli isolates ESBL producers is 90 % for Amoxicillin/clavulanate, 86% for Trimethoprim-sulfamethoxazole & Ciprofloxacin, 49% for Nitrofurantoin ,18% for Piperacillin/tazobactam and 2% for Imipenem & Amikacin . In K. pneumoniae ESBL producers isolates resistance rate is 91% for Nitrofurantoin, 73% for Amoxicillin/clavulanate, 64% for Ciprofloxacin & Trimethoprim-sulfamethoxazole and 18% for Piperacillin/ tazobactam. Polymerase chain reaction detected blaCTX-M in 42 of 70 (60 %) of E. coli and 5 of 16 (31%) of K. pneumoniae isolates. These bacteria demonstrated a significant increase in resistance rates to several non-β-lactam antibiotics and expressed a multidrug resistance phenotype at a high rate. This study poses a serious concern for infection control in Urology & Nephrology Center and indicates the need for immediate action to prevent further spread of these resistant bacteria.