Clinical and laboratory profile of urinary tract infections associated with extended spectrum-lactamase producing Escherichia coli and Klebsiella pneumoniae
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Date
2016
Journal Title
Journal ISSN
Volume Title
Type
Article
Publisher
International Journal of Green Economics
Association of Clinical Scientists
Association of Clinical Scientists
Series Info
Annals of Clinical and Laboratory Science
46
46
Doi
Scientific Journal Rankings
Abstract
Background. Urinary tract infection (UTI) is mainly due to invasion of the urethra, bladder or kidneys by pathogens. The emergence of extended spectrum �-lactamases (ESBL) is responsible for frequently observed empirical therapy failures. Objectives. To study the clinical and laboratory characteristics of UTIs caused by ESBL producing Escherichia coli (E. coli) and Klebsiella pneumonia (K. pneumonia). Methods. A cross-sectional clinical and laboratory study was performed at King Khalid Hospital, Hafr Al Batin, Saudi Arabia between March 2014 to October 2015. A total of 908 urine samples from suspected UTI patients was collected. Samples were isolated on Cysteine Electrolyte-Deficient (CLED) agar. Positive cultures were identified and tested for antimicrobial susceptibility by MicroScan WalkAway-96 SI System, and then ESBL was confirmed by double disc synergy test (DDST) and phenotypic confirmatory disc diffusion test (PCDDT). Results. A total of 680 samples (288 males and 392 females) were culture positive. 520 samples (76.5%)of E. Coli were found and 160 samples of K. pneumonia were identified (23.5%). ESBL testing showed 296 (218 E. coli and 78 K. pneumonia) samples of positive isolates. Non-ESBL isolates showed highest resistance to ampicillin followed by Mezocillin and Trimethoprim-Sulphamethoxazole- which are usually recommended as the initial treatment of UTI-while ESBL isolates showed resistance to third generation cephalosporin along with Ampicillin and Trimethoprim-Sulphamethoxazole. In this study, four significant risk factors for ESBL infection such as diabetes, recurrent UTI, previous use of antibiotics and previous hospitalization were found. Conclusion. Identifying the risk factors and antibiotic susceptibility patterns associated with ESBL producing E. coli and K. pneumonia is a useful guide for treatment strategy and control of ESBL UTI. 2016 by the Association of Clinical Scientists, Inc.
Description
Scopus
Keywords
October University for Modern Sciences and Arts, جامعة أكتوبر للعلوم الحديثة والآداب, University of Modern Sciences and Arts, MSA University, E . coli, ESBL, K. pneumonia, UTI, amikacin, amoxicillin plus clavulanic acid, ampicillin, antibiotic agent, cefazolin, cefepime, cefotaxime, cefoxitin, cefpodoxime, ceftazidime, ceftriaxone, cefuroxime, cephalosporin, ciprofloxacin, clavulanic acid, cotrimoxazole, ertapenem, extended spectrum beta lactamase, fosfomycin, gentamicin, imipenem, levofloxacin, mezlocillin, piperacillin plus tazobactam, tobramycin, beta lactamase, adolescent, adult, agar medium, antibiotic sensitivity, Article, bacterial growth, bacterium identification, bacterium isolate, child, controlled study, cross-sectional study, diabetic patient, double disc synergy test, extended spectrum beta lactamase producing Escherichia coli, extended spectrum beta lactamase producing Klebsiella pneumoniae, female, hospitalization, human, inhibition zone, laboratory test, major clinical study, male, microbiological examination, microbiology test, minimum inhibitory concentration, nonhuman, priority journal, recurrent infection, risk assessment, Saudi Arabia, urinary tract infection, urine sampling, biosynthesis, clinical laboratory service, demography, enzymology, Escherichia coli, infant, isolation and purification, Klebsiella pneumoniae, microbial sensitivity test, microbiology, middle aged, preschool child, urinary tract infection, young adult, Adolescent, Adult, beta-Lactamases, Child, Child, Preschool, Clinical Laboratory Services, Demography, Escherichia coli, Female, Humans, Infant, Klebsiella pneumoniae, Male, Microbial Sensitivity Tests, Middle Aged, Urinary Tract Infections, Young Adult