The distribution and characteristics of Extended-Spectrum β-Lactamase producing Escherichia coli and Klebsiella species among urinary isolates in a tertiary care hospital

A prospective study was carried out to determine the distribution of ESBL producing uropathogens in different units of a tertiary care hospital in Colombo and in community acquired UTIs presenting to this hospital. A total of 2303 urine samples from adult patients were received in the microbiology laboratory of the hospital during a four-month period, of which 626 were significant positive cultures. Escherichia coli and Klebsiella species accounted for 46% (n=286) of the total isolates with the majority (n=228, 80%) being E. coli. Thirty three percent (n=94) of these isolates produced extended-spectrum β-lactamases (ESBLs). Half (50%) of the Klebsiella isolates were ESBL producers while 29% of the E. coli produced ESBLs. Ten of 11 isolates in the intensive care unit and 6 of 8 in the genito-urinary unit were ESBL producers. The ESBL rate in the general medical and surgical wards and the out-patient department were 33% and 14% respectively. Out of the 181 isolates from community acquired UTIs, 13% produced ESBLs. Resistance to multiple drugs was considerably higher in ESBL positives compared to ESBL negative isolates. Urinary catheters, diabetes mellitus, previous antibiotic use, urinary tract abnormalities and recurrent urinary tract infections were associated with a higher risk of acquiring ESBL producing organisms (P<0.001).

DOI: http://dx.doi.org/10.4038/sljid.v2i2.4235

Sri Lankan Journal of Infectious Diseases Vol.2(2) 2012: 30-36