DefinePK

Abstract

Introduction: Health care-associated urinary tract infections (HAUTIs) are common and contribute to severe morbidity and high fatality rate in hospitalized patients. About 80% of HAUTIs occur in patients who undergo instrumentation of the urinary tract including catheter-associated urinary tract infections. The emergence of extended-spectrum β-lactamase (ESBL) is frequently associated with prolonged hospital stay, increased treatment cost, and limited treatment options especially wide-spectrum antibiotics. However, due to their widespread and mostly inappropriate usage, resistance to these medications has significantly grown, particularly as a result of the creation of extended-spectrum β-lactamase (ESBL).
Aim and Objective: To study the molecular characterization of extended spectrum β-lactamase (ESBL) producing E.coli isolates with associated gene to blaCTX and blaSHV gene from patients of urinary tract infections.
Material and Methods: This was a Cross sectional study carried out in the department of Microbiology for a period of 12 months i.e, September 2023 to September 2024. A total of 366 E. coli isolates of all the Uropathogenic E. coli strain which were  isolated from urine samples were collected from hospitalized and consultation patients in the study. The Antimicrobial susceptibility testing was performed according to the CLSI guidelines 2024. The DNA extraction was performed using the Qiagen DNA extraction kit and the gene blaCTX and blaSHV was detected using the PCR.
Results: In the present study out of the 1012 isolates there were 366 (36.1%) which showed the growth of E. coli. In which 82 (22.5%) were phenotypically identified as ESBL producers and 284 (77.6%) were Non-ESBL. Out of the 366 isolates, 110 (30%) were Males and  256 (69.9%) were Females patients. The overall susceptibility of ESBL isolates to various antibiotics was as  Ampicillin (17.20%), Ampicillin/Sulbactam (28.5%), Gentamycin (65.7%), Cefoxitin (51.0%), Amikacin (80%), Ciprofloxacin (48%), Meropenem (97.2%), Ceftazidime(0%), Ceftazidime/ clavunalate(100%), Piperacillin/tazobactam (85.7%), Ceftriaxone(0%), Nitrofurantoin(100%), Tigecycillin(97.2%) and fosfomycin(97.2%). In the current study out of the total 82 isolates there were 25 (30.4%) were observed positive for blaCTX gene and 11 (13.4%) observed positive for blaSHV gene.
Conclusion: There are now fewer treatment choices and increased medical costs as a result of the substantial expansion of E. coli that produces ESBL. Trends for regional epidemiological data on antimicrobial resistance must be updated to support appropriate antibiotic administration, effective infection control, and clinical care management.