Occurrence, Risk Factors and Antimicrobial Susceptibility Pattern of Extended-spectrum β-lactamases (ESBLs) Producing Escherichia coli and Klebsiella pneumoniae Isolated from Community-acquired Urinary Tract Infections

Abstract

The emergence of antimicrobial-resistant ESBL-producing Escherichia coli and Klebsiella pneumoniae among community-acquired uropathogens represents an important therapeutic challenge. Henceforth, the purpose of the study was to investigate the antibiotic susceptibility patterns of ESBL-producing Escherichia coli and Klebsiella pneumoniae among community-acquired urinary tract infections and then identify the risk factors. Escherichia coli and Klebsiella pneumoniae strains were isolated from patients with symptomatic community-acquired urinary tract infections. The ESBL-producing and antimicrobial susceptibility tests were then performed using the broth microdilution technique. Among 826 Escherichia coli and Klebsiella pneumoniae uropathogens, 17.43% were found to be ESBL producers. According to logistic regression analysis, the risk factors for ESBL-producing community-acquired urinary tract infections are urinary tract infections in the preceding 6 months and recurrent urinary tract infections. All ESBL producers were sensitive to meropenem, followed by imipenem (98.61%), amikacin sulfate (90.28%), and nitrofurantoin (80.56%). Significant ESBL-positive Escherichia coli and Klebsiella pneumoniae were identified which were found to be associated with recurrent UTIs. Meropenem was effective against both ESBL-positive and -negative bacteria.