Sajjad Hussain Mirza, Muhammad Salman, Umar Khurshid, Amin Wiqar.
CTX-M ESBL enzyme in Escherichia coli from urology patients in Rawalpindi, Pakistan.
J Pak Med Assoc Jan ;56(12):576-8.

Objective: To detect CTX-M phenotype utilizing disc diffusion and MIC testing in Escherichia coli isolated from a tertiary care urology setting. Methods: Fifty single, non duplicate ESBL producing isolates from a tertiary care urology hospital were evaluated for the presence of CTX-M phenotype. Initially all the urinary isolates were tested for ESBL production. The isolates were identified by using API 20E galleries and screened for ESBL production by combination disc methods. Representative 4 ESBL isolates were sent to Antibiotic Resistance Monitoring and Reference Laboratory (ARMRL), Health Protection Agency, Colindale, London, UK where those were further subjected to MIC testing by agar dilution and E-test strips. Results: A total of 4 ESBL producing E. coli isolates were characterized to be CTX-M on phenotypic characterization. The overall yield of CTX-M phenotypes was 75%. Conclusion: The emergence of CTX-M from Pakistan is alarming; however, further studies are required to study the epidemiology and genetic characterization of CTX-M types of ESBLs (JPMA 56:576;2006).

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