Community-acquired urinary tract infections by extended-spectrum beta-lactamase-producing Gram negative bacteria

Antibiotic resistance among uropathogens causing community acquired urinary tract infection (CAUTI) is increasing worldwide. Severity and endemicity persists despite of wide spread availability of drugs. Knowledge of the aetiology and antimicrobial susceptibility patterns of uropathogens is important in order to determine the best empiric treatment option. Extended-spectrum beta-lactamase (ESBL) producing strains of Enterobacteriaceae and other Gram negative bacteria are a cause of increasing concern. Delay in the detection and reporting of ESBL production by gram-negative bacteria is associated with prolonged hospital stay, increased morbidity, mortality and health-care cost. This study was aimed to determine the aetiology and antimicrobial susceptibility of uropathogens in culture-positive, CAUTIs. The incidence, MAR index and virulence characters of ESBL-producing strains were also analyzed. Double-disk synergy test (DDST) and E test was performed according to CLSI recommendation in order to detect the ESBL producers. In addition to antibiotic resistance, virulence characters like mucoid and hydrophobic nature of isolates,Protease and Biofilm production were studied. The commonest organism isolated was Escherichia coli and Klebsiella spp. Among the antibiotics tested,isolates were most susceptible to Amikacin ,Netilimicin and Gentamicin. Maximum resistance was observed with cephalosporins.ESBL production was predominant in Escherichia coli and Klebsiella spp. Most commonest virulence feature in the present study was found to be exopolysaccharide production