STUDY OF MAGNITUDE OF UTI CAUSED BY ESBL-PRODUCING ESCHERICHIA COLI AND ASSOCIATED RISK FACTORS
DOI:
https://doi.org/10.22159/ajpcr.2022.v15i6.43478Keywords:
UTI, Risk factors, ESBL, PCDDT, DDAT, E-test, Sensitivity, SpecificityAbstract
Objective: Globally, urinary tract infections (UTIs) caused by Escherichia coli that produce extended-spectrum lactamase (ESBL) have become more common. Our study determined the magnitude of UTI occurring due to ESBL-producing E. coli and associated risk factors. Different methods for their phenotypic detection were also compared.
Methods: Uropathogenic E. coli isolated in significant numbers were assayed microbiologically. E. coli isolates (n=247) that were found significant in number tested for ESBL production using three different phenotypic methods: Phenotypic combined disk diffusion test (PCDDT), double-disk approximation test (DDAT), and E-test for ESBL production. An antibiotic susceptibility test was performed for different antibiotics. Various risk factors associated with UTIs were correlated with ESBL- and non-ESBL-producing E. coli.
Results: We found that diabetes mellitus type 2 was the most common risk factor for UTI caused due to ESBL-producing E. coli (25%). Pregnant females and patients having recurrent UTI showed less positivity for ESBL production. DDAT detected 32 ESBL-positive isolates and PCDDT detected 37 positive isolates. E-test was taken as the gold standard for ESBL detection which detected 49 isolates as ESBL producers. The highest sensitivity (71.2%) and specificity (75%) were shown by PCDDT.
Conclusion: According to the study conducted, it was concluded that PCDDT was the most reliable and economic method for phenotypic detection of ESBL.
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References
Fan NC, Chen HH, Chen CL, Ou LS, Lin TY, Tsai MH, et al. Rise of community-onset urinary tract infection caused by extended-spectrum β-lactamase-producing Escherichia coli in children. J Microbiol Immunol Infect 2014;47:399-405. doi: 10.1016/j.jmii.2013.05.006, PMID 23834784
Calbo E, Romaní V, Xercavins M, Gómez L, Vidal CG, Quintana S, et al. Risk factors for community-onset urinary tract infections due to Escherichia coli harbouring extended-spectrum β-lactamases. J Antimicrob Chemother 2006;57:780-3. doi: 10.1093/jac/dkl035, PMID 16492721
Rodríguez-Baño J, Alcalá JC, Cisneros JM, Grill F, Oliver A, Horcajada JP, et al. Community infections caused by extended-spectrum beta-lactamase-producing Escherichia coli. Arch Intern Med 2008;168:1897-902. doi: 10.1001/archinte.168.17.1897, PMID 18809817
Wiegand I, Geiss HK, Mack D, Stürenburg E, Seifert H. Detection of extended-spectrum beta-lactamases among Enterobacteriaceae by use of semiautomated microbiology systems and manual detection procedures. J Clin Microbiol 2007;45:1167-74. doi: 10.1128/ JCM.01988-06, PMID 17287329
Stürenburg E, Lang M, Horstkotte MA, Laufs R, Mack D. Evaluation of the MicroScan ESBL plus confirmation panel for detection of extended-spectrum beta-lactamases in clinical isolates of oxyimino-cephalosporin-resistant gram-negative bacteria. J Antimicrob Chemother 2004;54:870-5. doi: 10.1093/jac/dkh449, PMID 15471997
Collee PE, Enright DP. Method and Composition for Preserving Core Sample Integrity using a Water Soluble Encapsulating Material. United States Patent US. Vol. 5. United States: Baker Hughes Inc.; 1996. p. 798.
Hoeprich PD. Culture of the urine. J Lab Clin Med 1960;56:899-907. PMID 13714928
Peterson EJ, Finegold SM. Bailey and Scott’s Diagnostic Microbiology. 11th ed. St. Louis: Mosby; 2002. p. 259-83.
Clinical and Laboratory Standards Institute. Performance Standard for Antimicrobial Susceptibility Testing. 22nd Informational Supplement. Vol. 32. United States: Clinical and Laboratory Standards Institute; 2016.
National Committee for Clinical Laboratory Standards. Performance Standards for Antimicrobial Disk Susceptibility Test. 7th ed., Vol. 20. Wayne PA; Approved Standards, NCCLS Document M2-A7; 1988. p. 867-78.
Boye A, Siakwa PM, Boampong JN, Koffuor GA, Ephraim RK, Amoateng P, et al. Asymptomatic urinary tract infections in pregnant women attending antenatal clinic in Cape Coast, Ghana. E3 J Med Res 2012;1:74-83.
New HC. Urinary tract infection. Am J Med 1996;100:63-70.
Jones RN. Impact of changing pathogens and antimicrobial susceptibility patterns in the treatment of serious infections in hospitalized patients. Am J Med 1996;100:3S-12S. doi: 10.1016/s0002-9343(96)00102-7, PMID 8678095
Kaper JB, Nataro JP, Mobley HL. Pathogenic Escherichia coli. Nat Rev Microbiol 2004;2:123-40. doi: 10.1038/nrmicro818, PMID 15040260
Saleem M, Daniel B. Prevalence of urinary tract infection among patients with diabetes in Bangalore city. Int J Emerg Sci 2011;1:133.
Acharya D, Bogati B, Shrestha GT, Gyawali P. Diabetes mellitus and urinary tract infection: spectrum of uropathogens and their antibiotic sensitivity. J Manmohan Mem Inst Health Sci 2015;1:24-8. doi: 10.3126/jmmihs.v1i4.11998
Vata A, Hunea IM, Dorneanu O, Harja-Alexa IA, Plesca C, Leonte- Enache G, et al. Biochemical changes and risk factors in the prognosis of antibiotics susceptibility in urinary tract infections. Rev ChimBuchar 2019;70:1822-5. doi: 10.37358/RC.19.5.7223
Mahesh E, Ramesh D, Indumathi VA, Khan MW, Kumar PS, Punith K. Risk factors for community acquired urinary tract infection caused by ESBL-producing bacteria. JIACM 2010;11:271-6.
Kumar S, Budhani D, Sayal P. Bacterial uropathogens and empirical treatment in urinary tract infection in a tertiary care institute. Int J Curr Microbiol Appl Sci 2016;5:47-54. doi: 10.20546/ ijcmas.2016.504.008
Sujatha R, Pal N. Antibiotic resistance pattern of the hospital and community acquired isolates of uropathogens in a teritiary care centre at Kanpur. Rama Univ J Med Sci 2015;1:10-7.
Singh RM, Singh HL. Comparative evaluation of six phenotypic methods for detecting extended-spectrum beta-lactamase-producing Enterobacteriaceae. J Infect Dev Ctries 2014;8:408-15. doi: 10.3855/ jidc.4052, PMID 24727505
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