Extended spectrum beta lactamases (ESBL):Preference for age and gender: A hospital based study

Abstract

Background: Antibiotic resistance is a challenge to treat. Extended Spectrum Beta Lactamases (ESBL) is one of the phenomenon by which the uropathogen express resistance to the commonly used antibiotic. Objectives: To determine the frequency of ESBL in uro-pathogens and ESBL preference for age and gender. Methods: This cross sectional study was conducted in Qazi Hussain Ahmed Medical Complex Nowshera from 1st Mar 2019 to 31st Jan 2020. A total of 315 urine samples were received for culture and sensitivity out of which 77 cases reported to be ESBL positive (24.44%). Relevant information’s were recorded in SPSS version 25. Results: A total of 77 cases with established ESBL phenomenon were studied. Fourty percent were males and 60% females. The frequency of ESBL positive isolates was (24.44%). In 71(92%) cases of ESBL, Escherichia coli strain was reported, Klebsiella pneumonia in 5(6.5%) and Proteus mirabilis in 1.3% cases. The difference in means +SD of age of the male gender (24.25years+9.6) was statistically significant with female gender (31.16years+14.49) (p-value 0.02). The probability of ESBL infections was 2.16 times higher in female gender (p-value: 0.01, OR:2.16). The sensitivity pattern of the ESBL producing Escherichia coli was; Imipenem(IMP) 100%, meropenem (Mem)100%, piperacillin tazobactam (TZP) 92%, nitrofurantoin (F)-85%. While imipenem & meropenem were drugs of choice for ESBL-Klebsiella pneumonia and ESBL-Proteus mirabilis. Conclusion: The frequency of ESBL isolates was 24.44%. Female gender reported more ESBL infection as compared to male gender. Escherichia coli ESBL was most common. The common sensitivity pattern to ESBL was: Imipenem(IMP) 100%, meropenem (Mem)100% and piperacillin tazobactam 95%.