Phenotypic detection of Extended Spectrum β-Lactamases (ESBL) among gram negative uropathogens reveals highly susceptibility to imipenem

Detection of ESBL among gram negative uropathogens

  • Isra Mohammed College of Graduate Studies, Sudan University of Science and Technology, P.O. Box 407, Khartoum, Sudan
  • Elfadil Abass Imam Abdulrahman Bin Faisal University, Kingdom Saudi Arabia
Keywords: ESBL, Gram Negative, Phenotypic Detection, Pregnant women

Abstract

Objective: We aimed to determine antibiotic susceptibility patterns of ESBL- and non-ESBL bacteria isolated from pregnant women with UTI in antenatal wards in Khartoum State, Sudan.

Methods: This cross-sectional study was conducted during April-July 2016 at different hospitals in Khartoum State. Mid-stream urine samples were obtained from 150 hospitalized pregnant women and cultured on CLED (Cystine Lactose Electrolyte Deficient) agar. Microorganisms were identified using standard microbiological procedures. Isolated Gram-negative bacteria were tested for antibiotic susceptibility and ESBL screening using modified Kirby- Bauer method and Double Disc Synergy Test (DDST) respectively.

Results: Urine culture revealed positive results in 33/150 (22%) and the most prevalent isolates were Gram negative bacteria (18/33, 54.5%). Among gram-negative bacteria, isolates of E. coli were the most prevalent accounting 66.6% (12/18) followed by K. pneumoniae (4/18, 22.2%) and K. oxytoca (2/18, 11.1%). ESBL was detected in 8/18 (44.4%) of the Gram-negative isolates. Of note, imipenem was the most susceptible antibiotic for ESBL-producer and non-ESBL producer Gram negative isolates, accounting 100% susceptibility for both bacterial groups. Overall susceptibility rates were also high for ciprofloxacin (13/18, 72.2%). In other hand, co-trimoxazole and amoxicillin showed high resistance pattern for ESBL-producer and non-ESBL producer isolates; 27.8%, 44.4% and 38.9%, 38.9% susceptibility rates of co-trimoxazole and amoxicillin for ESBL-producer and non-ESBL producer isolates, respectively.

Conclusions: Imipenem remains the most powerful option for ESBL- and non-ESBL bacteria causing UTIs in pregnant women. However, due to tremendous increase of antibiotic-resistant, antibiotic-susceptibility testing is recommended as a routine investigation for admitted pregnant women.

doi: https://doi.org/10.12669/pjms.35.4.207

How to cite this:
Mohammed I, Abass E. Phenotypic detection of Extended Spectrum β-Lactamases (ESBL) among gram negative uropathogens reveals highly susceptibility to imipenem. Pak J Med Sci. 2019;35(4):1104-1109.
doi: https://doi.org/10.12669/pjms.35.4.207

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Published
2019-07-10
Section
Original Articles