Community Urinary Tract Infection due to ESBL producing E. coli: epidemiology and susceptibility to oral antimicrobials including Mecillinam

Abstract

Background: There is increasing incidence of (Extended spectrumbeta lactamases) ESBL producing E. coli causing community urinary tract infections (UTI). The primary objective of this study was to study the epidemiological factors associated with ESBL positive community acquired uropathogenic E. coli isolates and to determine their susceptibility to newer oral drugs including mecillinam. Methods: In this prospective study, from total of 140 community isolates of E. coli causing UTI, ESBL was detected by Clinical Laboratory Standards Institute criteria. Drug susceptibility was done by Kirby-Bauer method disc diffusion method for various oral antimicrobial agents. Various epidemiological factors associated with ESBL for each patient were recorded on individual forms. This included age, presence of diabetes mellitus, renal calculi, pregnancy, history of urinary instrumentation, recurrent UTI and antibiotics intake. Results: Out of total of 140 strains of E. coli, which were screened for ESBL production, 30 (21.4%) isolates were positive. High-level resistance 94 (70%) was seen for many antimicrobial agents. Only4.5% of uropathogenic E. coli were resistant to Mecillinam. Various epidemiological factors associated with ESBL causing infections were female patients, H/o antimicrobial intake, elderly age > 60 years, renal calculi and H/o recurrent UTI. Conclusions: The epidemiology of ESBL positive uropathogenic E. coli is becoming more multifaceted. Nepal Journal of Medical Sciences | Volume 03 | Number 01 | January-June 2014 | Page 5-7 DOI: http://dx.doi.org/10.3126/njms.v3i1.10341