Majda Qureshi, Najma Asif, Summyia Baig.
Evaluation of extended spectrum beta - lactamase mediated resistance in escherichia coli and klebsiella in urinary tract infection at a tertiary care hospital.
Biomedica Jan ;29(2):78-81.

Introduction: Urinary tract infections (UTIs) caused by extended – spectrum beta lactamase (ESBL) – producing bacteria have become a growing problem due to emerging antibiotic resistance. This observational study was carried out from January 2012 to August 2012 to see the frequency and antibiotic susceptibility of ESBL producers E.coli and KI.pneumoniae in urinary tract infection. Materials and Methods: A total of 672 urine sample received at Microbiology laboratory of Shalamar Medical College, Lahore and processed for culture / sensitivity. Results: On culture 256 isolates were obtained, of which 163 isolates were identified by AP120E as E.coli 125 (76.3%) and K.pneumoniae 38 (23.3%). The ESBL producing E.coli 90 (72%) and Klebsiella pneumoniae 25 (65.8%) were detected by double disc synergy test (DDST). Sensitivity testing showed a multidrug resistance in ESBL producing E.coli and K.pneumoniae. Maximum resistance recorded in E.coli (ESBL) was as cafatoxime (98.9%), Ceftazidime (96.7%) and Cefuroxime (93.4%) while minimum resistance was seen with Imipenum (0.8%) fosfomycine (1.2%) and Nitrofurantoin as well piperacillin / tazobactam (2.2%) each. The ESBL producing Klebsiella showed maximum resistance tocetoceftazidime (100%) cefotaxime (89%) Cefuroxime (84%) while minimum resistance seen with imipenam (4%) Nitrofurantoin and Piperacillin / Tazobactam (8%). Conclusion: ESBL producing bacteria, area matter of concern in high frequency of antimicrobial resistance to non beta lactam and aminoglycocides antibiotics. Monitoring of ESBL production and antimicrobial susceptibility testing are necessary to avoid treatment failure in patients with UTI.

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