Introduction: Community acquired urinary tract infections (CA-UTI) are commonly caused by Escherichia coli and Klebsiella spp which are known extended spectrum beta lactamase (ESBL) producers. Objectives: To determine, the prevalence and characteristics of ESBL producing of E. coli and Klebsiella spp in the community, and the association of risk factors with ESBL CA-UTI. Methods: Descriptive cross-sectional study with urine cultures performed from clinically suspected CA-UTI patients by CLSI standards. Conventional multiplex PCR was performed for gene analysis. Results: Cultures were positive in 178 (38%) patients from 465. Majority were females (103, 58%). Most frequently isolated was E. coli (149, 84%) with 68(46%) ESBL producers followed by 16(9%) Klebsiella pneumoniae with 4 (25%) ESBL producers. Majority of patients with ESBL CA-UTI were >50 yrs (35/72, 49%) and 13 (18%) children <10 years were present. ABST of ESBL producers revealed high resistance rates for quinolones (41%) and >80% sensitivity for nitrofurantoin, fosfomycin, mecillinam, aminoglycosides and carbapenems. Presence of ESBL genes were 83% CTX –M, 71% OXA, 24% TEM and 9% SHV with one organism often producing more than one gene in 29 isolates (71%). Haematuria and structural abnormalities of urinary tract were significantly associated with increased ESBL CA-UTI (p<0.01). Conclusions: ESBL prevalence of this community was 40% in CA-UTI with E.coli predominance among female majority. >80% ESBL organisms show high sensitivity for aminoglycosides, carbapenems, nitrofurantoin, mecillinam and fosfomycin. Frequently isolated ESBL gene was CTX-M. Haematuria and structural abnormalities of urinary tract were significantly associated with ESBL CA-UTI
Introduction: Community acquired urinary tract infections (CA-UTI) are commonly caused by Escherichia coli and Klebsiella spp which are known extended spectrum beta lactamase (ESBL) producers. Objectives: To determine, the prevalence and characteristics of ESBL producing of E. coli and Klebsiella spp in the community, and the association of risk factors with ESBL CA-UTI. Methods: Descriptive cross-sectional study with urine cultures performed from clinically suspected CA-UTI patients by CLSI standards. Conventional multiplex PCR was performed for gene analysis. Results: Cultures were positive in 178 (38%) patients from 465. Majority were females (103, 58%). Most frequently isolated was E. coli (149, 84%) with 68(46%) ESBL producers followed by 16(9%) Klebsiella pneumoniae with 4 (25%) ESBL producers. Majority of patients with ESBL CA-UTI were >50 yrs (35/72, 49%) and 13 (18%) children <10 years were present. ABST of ESBL producers revealed high resistance rates for quinolones (41%) and >80% sensitivity for nitrofurantoin, fosfomycin, mecillinam, aminoglycosides and carbapenems. Presence of ESBL genes were 83% CTX –M, 71% OXA, 24% TEM and 9% SHV with one organism often producing more than one gene in 29 isolates (71%). Haematuria and structural abnormalities of urinary tract were significantly associated with increased ESBL CA-UTI (p<0.01). Conclusions: ESBL prevalence of this community was 40% in CA-UTI with E.coli predominance among female majority. >80% ESBL organisms show high sensitivity for aminoglycosides, carbapenems, nitrofurantoin, mecillinam and fosfomycin. Frequently isolated ESBL gene was CTX-M. Haematuria and structural abnormalities of urinary tract were significantly associated with ESBL CA-UTI