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Insight Bacteriology
Year: 2013  |  Volume: 2  |  Issue: 2  |  Page No.: 10 - 14

A Study of Prevalence of Extended-spectrum β Lactamase Producing Enterobacteriaceae from Urinary Isolates in Community Setting

Syeda Nusheen Fathima, Lolith lohidakshan and Manju Samson    

Abstract: Background:The development of drug resistance due to Extended Spectrum β-Lactamase (ESBL) makes it essential to have current knowledge on antimicrobial susceptibility pattern of uropathogens for appropriate therapy. ESBLs at present are regarded as a major problem across the world and are gradually spreading both in hospital as well as in community settings. Their occurrence varies from different countries and healthcare institutions. Aim of this study: Hence, we made an endeavor to study the prevalence of extended-spectrum β lactamase producing Enterobacteriaceae from urinary isolates in community setting at the Microbiology Laboratory of Premier diagnostic centre division of Prime healthcare group, Dubai, United Arab Emirates. Methods: A total of 2134 consecutive, nonreplicate fresh samples of urine were subjected to study from December 2011 to March 2012. Out of which, 200 gram-negative isolates belonging to the family of Enterobacteriaceae adjudged to be clinically relevant to the patient’s infection were studied for ESBL production and associated resistance to a panel of antibiotics. The method used to detect ESBL production was BD Phoenix Automated ESBL detection system (Becton, Dickinson, Md., USA). Results: The tests were performed and interpreted to obtain the results, according to the manufacturer’s instructions. Out of 200 isolates belonged to Enterobacteriaciae, 22(11%) were ESBL producers. Prevalent ESBL producers identified by BD Phoenix were E. coli 20(10%) and K. pneumoniae 2(1%). Additional finding was, 5(2.5%) and isolates were potential carbapenemase producers. Most active drugs against ESBL-positive isolates were Meropenem (100%) Imipenem (100%) and Piperacillin/tazobactam combination (100%). Susceptibility to ciprofloxacin (25%), gentamicin (65%) trimethoprin/sulphamethoxazole (7.7%) was fairly low, whereas 100% of ESBL-producing enterobacteriaceae were susceptible to amikacin and 86% of the isolates were susceptible to nitrofurantoin. Conclusion: The outcome in this study documents the emerging threat of ESBL pathogens with the occurrence of these strains as etiological agents of infection in the community. Hence, we support urgent need for regular screening and surveillance of these organisms. We also recommend to restrict the redundant use of antibiotics, this could have lead to the progression of drug resistance in the community in large.

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