Extended-Spectrum Beta-Lactamase Producing Escherichia coli and Klebsiella pneumoniae are Emerging as Major Pathogens Responsible for Urinary Tract Infection

Authors

  • Sarwar Iqbal Associate Professor, Department of Nephrology, BIRDEM General Hospital, Dhaka
  • Muhammad Abdur Rahim Assistant Professor, Department of Nephrology, BIRDEM General Hospital, Dhaka
  • Tabassum Samad Registrar, Department of Nephrology, BIRDEM General Hospital, Dhaka
  • Mehruba Alam Ananna Assistant Professor, Department of Nephrology, BIRDEM General Hospital, Dhaka
  • Palash Mitra Assistant Registrar, Department of Nephrology, BIRDEM General Hospital, Dhaka
  • Tufayel Ahmed Chowdhury Registrar, Department of Nephrology, BIRDEM General Hospital, Dhaka

DOI:

https://doi.org/10.3329/bccj.v3i2.25109

Keywords:

Escherichia coli, extended-spectrum beta-lactamase, Klebsiella pneumoniae, urinary tract infection

Abstract

Background: Escherichia coli and Klebsiella pneumoniae are two common organisms responsible for urinary tract infection (UTI) world-wide. Extended-spectrum beta-lactamase (ESBL) producing E. coli and K. pneumoniae are increasingly being reported as urinary isolates.

Objectives: This study was aimed to describe the frequency of ESBL positive E. coli and K. pneumoniae causing UTI, associated risk factors and antibiotic sensitivity pattern of these organisms.

Methods: This prospective cross-sectional study was conducted in BIRDEM General Hospital from January 2014 to March 2014. One hundred consecutive culture positive UTI cases due to E. coli or K. pneumoniae infection, irrespective of ESBL positivity were purposively included in this study. UTI due to organisms other than E. coli and K. pneumoniae and culture negative cases were excluded from the study.

Results: Total patients were 100, male were 21 and female 79. Mean age was 59.1 (range 19-81) years. Out of 100 patients, 96 were diabetic. Fever, vomiting, dysuria and increased urinary frequency were common symptoms. Among the 100 culture positive samples, E. coli were 84 and K. pneumoniae were 16. Forty eight (48/84, 57.1%) of E. coli and 10 (10/16, 62.5%) of K. pneumoniae were ESBL positive. Female patients, presence of diabetes mellitus (DM), long duration and poor control of DM, chronic kidney disease (CKD), renal stone and past history of UTI were significant risk factors for ESBL positivity. Amikacin, netilmycin and imipenem were among the most sensitive antibiotics.

Conclusion: Two-thirds of the E. coli and K. pneumoniae in this study were ESBL positive. Female gender with poor control of DM, CKD and past history of UTI were significant risk factors for ESBL positivity. Aminoglycosides and carbapenems remain the drug of choice.

Bangladesh Crit Care J September 2015; 3 (2): 49-52

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Author Biography

Sarwar Iqbal, Associate Professor, Department of Nephrology, BIRDEM General Hospital, Dhaka



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Published

2015-09-22

How to Cite

Iqbal, S., Rahim, M. A., Samad, T., Ananna, M. A., Mitra, P., & Chowdhury, T. A. (2015). Extended-Spectrum Beta-Lactamase Producing Escherichia coli and Klebsiella pneumoniae are Emerging as Major Pathogens Responsible for Urinary Tract Infection. Bangladesh Critical Care Journal, 3(2), 49–52. https://doi.org/10.3329/bccj.v3i2.25109

Issue

Vol. 3 No. 2 (2015)

Section

Original Articles

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