Extended-Spectrum Beta-Lactamases Producing Microorganisms isolated from UTI Patients: an Alarm

UTI is one of the commonest infections encountered by clinicians and Extended— spectrum beta-lactamases in UTI patients have emerged as a major threat worldwide. Due to extensive use of β-lactam antibiotics over the last several decades in the clinical practice various β-lactamases have emerged and despite the worldwide availability of antimicrobial agents. UTI has become difficult to treat because of appearance of pathogens with increasing resistance to antimicrobial agents because of ESBL producers. The objective of this study is to provide a better understanding of ESBL producing organisms in UTI patients and to isolate and identify the bacterial pathogen from clinical samples and to determine their antibiotic susceptibility pattern of isolates in the tertiary care hospital, S.N. Medical College of North India. This study was carried out in S.N. Medical College, Agra (Uttar Pradesh), India from January 2016 to July 2016. Out of the total 1,106 urine samples were tested for the bacterial growth and their antibiotic sensitivity tests was done by the Kirby Bauer disc diffusion method. Out of 1,106 urine samples, 325 (29.38%) samples was positive and included in the final analysis. Among ESBL producing Gram negative uropathogens Escherichia coli (65.43%) was the most common isolate followed by Klebsiella pneumoniae (66.66%) and Proteus mirabilis (66.67%). These were found to be highly susceptible to Carbapenems such as Imipenem, Meropenem (95.06%), and for Amikacin (83.95%) and Nitroflurontoin (85.19%)). Among Gram positive cocci Staphylococcus aureus and Enterococcus faecalis were found to be 100% sensitive for Vancomycin and Teicoplanin and 83.78% for Nitroflurontoin. The most frequently identified ESBL producing uropathogens in the study were E coli and Klebsiella pneumoniae and Proteus mirabilis show increasing resistance pattern to the commonly used or prescribed drugs in health settings that in turn leaves the clinicians with very few alternative options of drugs for the treatment of UTIs. Imipenem, Meropenem, Amikacin and Nitrofiurontoin in case of Gram negative ESBL producers and Vancomycin, Teicoplanin and Nitroflurontoin showed a good antimicrobial activity against uropathogens. They may represent good option for the empirical treatment of patients with UTI. K e y w o r d s