Clinical Significance of ESBL-Producing Escherichia coli Isolated from Urinary Tract Infections in Sylhet Bangladesh

Abstract

The prevalence of extended-spectrum b-lactamases (ESBL) producing E. coli in the town of Sylhet was assessed over 12months period. One hundred patients who had symptomatic urinary tract infections were selected for this study and urine samples were collected from the private laboratories of the community. These isolates were further confirmed as ESBL-producing E. coli by phenotypic methods were identified and selected. Patients having urinary tract infection showed 72% were female and the rest 28% were male. The investigations were carried out on female population only. The patient’s age ranged from 4years to 60years. The highest age incidence of UTI patient was 21-30years (28%) followed by 31-40years (20%). Patients in the age range 41-50years showed15% and patients above 50years 19%. The antibiotic susceptibility test for non-ESBL showed 100% sensitivity to imipenem and meropenem. There was multidrug resistance to amoxicillin-clavulanic acid 30% ceftazidime 40%, ceftriaxone 35%, and ciprofloxacin 60%. The ESBL group was also 100% sensitive to carbapenems and the rest of resistance by percentage were amoxicillin-clavulanic acid -80%, ceftazidime-55%, ceftriaxone-80%, ciprofloxacin 80%. The ESBL and non ESBL producing strains were separated for plasmid profile analysis. The plasmid profile showed 60% of isolates exhibit high molecular weight plasmids (>140MDa) in ESBL groups and similar results were seen in Non ESBL groups (64%). These findings suggests that both ESBL and non ESBL producing isolates harbour large size plasmids, despite the fact that ESBL–producing strains cause wide range of multi-drug resistance in the community.