Detection of Extended-spectrum β-lactamases’ (ESBLs) Resistance among Urinary Tract Pathogens in Khartoum State

Abstract

Aims: The aim of this study is to isolate and identify the extended spectrum beta lactamase (ESBLs), the causative agents of urinary tract infection and detection of their resistance against β lactam drugs. Study Design: Descriptive cross sectional studies in which 100 patients with UTI. Place and Duration of Study: This study was conducted at the Department of Microbiology, Faculty of Medical Laboratories Science, Al-Neelain University, Khartoum – Sudan from “1st September to 31thDecember 2014. Methodology: One hundred urine samples were collected from Khartoum state Hospitals and identified on the basis of their culture characteristics and morphological appearance using Gram stain technique and biochemical tests. The isolates were subjected to antimicrobial susceptibility against the third generation cephalosporins (Cefotaxime, Ceftazidime and Ceftriaxone) using Disk-Diffusion method. The bacterial isolates were inoculated to show their ability to produce ESBL using Combination Disk Method (Calvulanic acid + Third generation cephalosporins). The ESBL producers were evaluated among non-ESBL producers. Results: The isolates were identified and enumeratetd as E. coli (49), Proteus species (15), Klebsiella pneumoniae (18), Pseudomonas aeruginosa (9), Enterococcus faecalis (7) and 2 Gram positive bacteria (Staphylococcus species). The isolates subjected were found to show their antibacterial susceptibility against third generation cephalosporins (Cefotaxime, Ceftazidime, and Ceftriaxone) and the results observed were that sixty out of one hundred isolates depicted resistance to third generation cephalosporins and it included E. coli (29), Klebsiella pneumoniae (18), Proteus species (7), Pseudomonas aeruginosa (4) and Enterococcus faecalis (2). Among sixty bacterial species that showed resistance to the third generation cephalosporins, E. coli 20(68%), Klebsiella pneumoniae 7(38%), Proteus species 3(42%) and Enterococcus faecalis 1(50%) respectively were found to be ESBL producer. Pseudomonas aeruginosashowed non-ESBL producers. Conclusion: We conclude that the ESBL producers were found in large proportion which may be due to the misuse of antibiotics or inadequate treatment.