Uropathogenic Escherichia coli is the main uropathogen involved in community and hospital acquired urinary tract infections. The increased rate of resistance towards different classes of antibiotics limits the treatment options for such infections. This study aim to determine the local resistance rate against different classes of antibiotics that are commonly used in treatment of urinary tract infections. Also to determine the rate of ESBL production and the correlation with other antibiotic resistance among producing isolates.
In this study, 112 UPEC isolates were collected from patients who were suffered from symptoms of UTIs, antibiotic susceptibility was determined by disk diffusion method against β-lactams, fluoro-quinolones, folate pathway inhibitors, aminoglycosides, tetracyclines and nitrofurans. Also, Extended spectrum β-lactamase (ESBL) production rate was determined based on the observed reduction in susceptibility towards β-lactams antibiotics in routine susceptibility testing which confirmed using double disk synergy test.
The UPEC isolates exhibited increased resistance rate towards different antibiotic classes especially sulphamethoxazole-trimethoprim, fluoro-quinolones and β-lactams which are mainly used in the treatment. About 50% of UPEC isolates were found to be ESBL producing. The ESBL producing isolates exhibited high resistance rate towards non β-lactam antibiotic especially sulphamethoxazole-trimethoprim and fluoro-quinolones (67.8% and 63% respectively.) along with other antibiotics. However, ESBL producing isolates exhibited low resistance against piperacilin-tazobactam, nitrofurantoin, imipenem and meropenem (17.8%, 16%,3.5% and 1.7%, respectively). Therefore, it is recommended to use piperacilin-tazobactam, nitrofurantoin, imipenem or meropenem in treatment of UPEC resistant strains