Isolation and Identification of UTI Causing Agents and Frequency of ESBL (Extended Spectrum Beta Lactamase) in Pakistan

Objective: The objectives of the current study were to isolated and identified UTIs causative agents. To identify the frequency of ESBL producing microorganisms. These findings will help to manage UTIs infections in Pakistani population.
Methods: A total of 1050 outdoor patient’s samples were collected by the mid-stram methods. The samples were tested microbiologically by using standard procedure. Antibiotic susceptibility of the isolated pathogens was tested for commonlyused antibiotics by Kirby-Bauer technique according to NCCLS guidelines.
Results: Out of these 225 (21%, p < 0.05) samples were found positive for urinary tract infection (UTI). Prevalnace was higher in female 126 (56%, p < 0.05) then male 99 (44%, p ≤0.01) with age group of 41- 50 years. Among total 199 gram negative isolates 121 (61%) were ESBL positive E Coli 68 (56%) was common followed by Pseudomonas aerogenosa 22 (18%), Klebsiella sp. 21 (17%) and Proteus sp. 10 (8%). Antibiotic susceptibilities of ESBL producing isolates were resistant to Levofloxacin 97 (80%), Tobramycin 72 (60%) and pipemidic acid 73 (60.3%) as compared to ESBL nonproducing isolates.
Conclusion: Overall prevalence of UTI observed in our study is 21%. E. coli was most prevalent than other organism, most common in female than male age group of 41- 50. ESBL positive were highly resistant to antibiotics as compared to Non-ESBL. This high prevalence of resistant ESBL posing a major clinical crisis of treatment failure with β-lactam antimicrobials. ESBL detection and their antibiotic susceptibility checking should be included in every pathological laboratory to restrict the over and misuse of the antibiotics and to improve the treatment and management of UTI.

Author(s): Amna Kausar, Muhammad Akram, Muhammad Shoaib, Raja Tahir Mehmood, M. Nazeer Abbasi, Muhammad Adnan, Dr. Hafsa Aziz and M. Javaid Asad

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