Distribution of ESBLs among Escherichia coli isolates from outpatients with recurrent UTIs and their antimicrobial resistance

Introduction: Extended-spectrum β-lactamase (ESBL)-producing strains of Enterobacteriaceae are considered to be emerging pathogens. They are a major problem in hospitalized as well as community-based patients. Major outbreaks involving ESBL strains have been reported from all over the world. Recurre...

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Main Authors: Sareaa Al-Mayahie, Jaafar JH Al Kuriashy
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2016-06-01
Series:Journal of Infection in Developing Countries
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Online Access:https://jidc.org/index.php/journal/article/view/6661
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author Sareaa Al-Mayahie
Jaafar JH Al Kuriashy
author_facet Sareaa Al-Mayahie
Jaafar JH Al Kuriashy
author_sort Sareaa Al-Mayahie
collection DOAJ
description Introduction: Extended-spectrum β-lactamase (ESBL)-producing strains of Enterobacteriaceae are considered to be emerging pathogens. They are a major problem in hospitalized as well as community-based patients. Major outbreaks involving ESBL strains have been reported from all over the world. Recurrent urinary tract infection (UTI) is one of the risk factors for infection with ESBL-producing E. coli in hospitalized and non-hospitalized patients. Methodology: Ninety-one E. coli isolates from outpatients with recurrent UTIs were surveyed phenotypically and genotypically for ESBL production and tested for antimicrobial susceptibility. Results: Of 91 E. coli isolates, 75.8% were resistant to each of cefotaxime and ceftazidime and 74.7% produced ESBLs. CTX-M-type was the most frequent ESBL (accounting for 70.3%), with CTX-M-1 being the only subtype possessed by these isolates. The prevalence of OXA- and SHV-type was 32.9% and 10.9%, respectively. None of the isolates produced TEM β-lactamase. All OXA-type ESBL were produced concomitantly with CTX-M1. Both ESBL producers and non-producers had high resistance to ampicillin followed by trimethoprim-sulphamethoxazole, third-generation cephalosporins, and tetracycline. No isolate showed resistance to imipenem and meropenem. In total, resistance rates of ESBL producers were higher than those of ESBL non-producers, as was multidrug resistance (52.7% versus 8.7%, respectively). Conclusions: Our study documented high distribution of ESBLs among E. coli isolates from outpatients with recurrent UTIs, with CTX-M as the predominant ESBL. In the current situation, it is important that antibiotic treatment is be started only after a proper sensitivity report is obtained from the laboratory.
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spelling doaj-art-f78a749a42c141f3a7e9af1f6d7e12fc2025-08-20T03:52:43ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802016-06-01100610.3855/jidc.6661Distribution of ESBLs among Escherichia coli isolates from outpatients with recurrent UTIs and their antimicrobial resistanceSareaa Al-Mayahie0Jaafar JH Al Kuriashy1Wasit University, Wasit Province, IraqWasit University, Wasit Province, IraqIntroduction: Extended-spectrum β-lactamase (ESBL)-producing strains of Enterobacteriaceae are considered to be emerging pathogens. They are a major problem in hospitalized as well as community-based patients. Major outbreaks involving ESBL strains have been reported from all over the world. Recurrent urinary tract infection (UTI) is one of the risk factors for infection with ESBL-producing E. coli in hospitalized and non-hospitalized patients. Methodology: Ninety-one E. coli isolates from outpatients with recurrent UTIs were surveyed phenotypically and genotypically for ESBL production and tested for antimicrobial susceptibility. Results: Of 91 E. coli isolates, 75.8% were resistant to each of cefotaxime and ceftazidime and 74.7% produced ESBLs. CTX-M-type was the most frequent ESBL (accounting for 70.3%), with CTX-M-1 being the only subtype possessed by these isolates. The prevalence of OXA- and SHV-type was 32.9% and 10.9%, respectively. None of the isolates produced TEM β-lactamase. All OXA-type ESBL were produced concomitantly with CTX-M1. Both ESBL producers and non-producers had high resistance to ampicillin followed by trimethoprim-sulphamethoxazole, third-generation cephalosporins, and tetracycline. No isolate showed resistance to imipenem and meropenem. In total, resistance rates of ESBL producers were higher than those of ESBL non-producers, as was multidrug resistance (52.7% versus 8.7%, respectively). Conclusions: Our study documented high distribution of ESBLs among E. coli isolates from outpatients with recurrent UTIs, with CTX-M as the predominant ESBL. In the current situation, it is important that antibiotic treatment is be started only after a proper sensitivity report is obtained from the laboratory. https://jidc.org/index.php/journal/article/view/6661E. colirecurrent UTIESBLantimicrobial susceptibility
spellingShingle Sareaa Al-Mayahie
Jaafar JH Al Kuriashy
Distribution of ESBLs among Escherichia coli isolates from outpatients with recurrent UTIs and their antimicrobial resistance
Journal of Infection in Developing Countries
E. coli
recurrent UTI
ESBL
antimicrobial susceptibility
title Distribution of ESBLs among Escherichia coli isolates from outpatients with recurrent UTIs and their antimicrobial resistance
title_full Distribution of ESBLs among Escherichia coli isolates from outpatients with recurrent UTIs and their antimicrobial resistance
title_fullStr Distribution of ESBLs among Escherichia coli isolates from outpatients with recurrent UTIs and their antimicrobial resistance
title_full_unstemmed Distribution of ESBLs among Escherichia coli isolates from outpatients with recurrent UTIs and their antimicrobial resistance
title_short Distribution of ESBLs among Escherichia coli isolates from outpatients with recurrent UTIs and their antimicrobial resistance
title_sort distribution of esbls among escherichia coli isolates from outpatients with recurrent utis and their antimicrobial resistance
topic E. coli
recurrent UTI
ESBL
antimicrobial susceptibility
url https://jidc.org/index.php/journal/article/view/6661
work_keys_str_mv AT sareaaalmayahie distributionofesblsamongescherichiacoliisolatesfromoutpatientswithrecurrentutisandtheirantimicrobialresistance
AT jaafarjhalkuriashy distributionofesblsamongescherichiacoliisolatesfromoutpatientswithrecurrentutisandtheirantimicrobialresistance