ESBL Production Among E. coli and Klebsiella spp. Causing Urinary Tract Infection: A Hospital Based Study.

Q3 Immunology and Microbiology

Open Microbiology Journal Pub Date : 2017-04-28 eCollection Date: 2017-01-01 DOI:10.2174/1874285801711010023

Pooja Shakya, Dhiraj Shrestha, Elina Maharjan, Vijay K Sharma, Rabin Paudyal

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引用次数: 95

Abstract

Introduction: Increase in extended-spectrum β-lactamases (ESBL) producing microbes in recent years has led to limitations of treatment options. This study aimed to assess the prevalence of ESBL producing E. coli and Klebsiella spp. at a tertiary hospital in Nepal.

Methods: A total of 2209 non-repetitive mid-stream urine (MSU) samples were collected during the study period (March to September 2014). Identification of the isolates was done by Gram's staining followed by biochemical tests. Antibiotic susceptibility testing was done by modified Kirby-Bauer disc diffusion method and interpretation was done following Clinical and Laboratory Standard Institute (CLSI) guidelines, 2013. ESBL screening among E. coli and Klebsiella spp. isolates were done using ceftriaxone, cefotaxime, ceftazidime and cefpodoxime. The confirmation was done by phenotypic disc diffusion test (combined disc method) using ceftazidime (30µg) and ceftazidime plus clavulanic acid (30/10µg), and cefotaxime (30µg) and cefotaxime plus clavulanic acid (30/10µg) disc as per CLSI guidelines.

Results: A total of 451 samples showed significant bacteriuria with 365 (80.9%) E. coli, 17 (3.8%) Klebsiella pneumoniae and 3 (0.7%) Klebsiella oxytoca. Of 451 isolates, 236 (52.3%) were found MDR strains. By combined disk test, 33 (91.7%) E. coli and 3 (8.3%) Klebsiella spp. were found ESBL producers.

Conclusion: Higher prevalence of ESBL producing E. coli and Klebsiella spp. was observed warranting prompt need of surveillance for effective management of such MDR strains.

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引起尿路感染的大肠杆菌和克雷伯菌产生ESBL:一项基于医院的研究

近年来，广谱β-内酰胺酶(ESBL)产生微生物的增加导致了治疗选择的局限性。本研究旨在评估尼泊尔一家三级医院产生ESBL的大肠杆菌和克雷伯氏杆菌的流行情况。方法:在研究期间(2014年3月至9月)共收集2209份非重复中游尿液(MSU)样本。采用革兰氏染色法对分离菌株进行鉴定，然后进行生化试验。抗生素药敏试验采用改良Kirby-Bauer盘片扩散法进行，并按照临床和实验室标准协会(CLSI) 2013年指南进行解释。采用头孢曲松、头孢噻肟、头孢他啶和头孢多肟对大肠杆菌和克雷伯氏菌分离株进行ESBL筛选。根据CLSI指南，采用头孢他啶(30µg)和头孢他啶加克拉维酸(30/10µg)、头孢噻肟(30µg)和头孢噻肟加克拉维酸(30/10µg)光盘进行表型圆盘扩散试验(联合圆盘法)进行证实。结果:451份标本检出明显菌尿，其中大肠杆菌365例(80.9%)，肺炎克雷伯菌17例(3.8%)，产氧克雷伯菌3例(0.7%)。在451株分离物中，发现236株耐多药菌株(52.3%)。联合圆盘试验检出大肠杆菌33株(91.7%)，克雷伯氏菌3株(8.3%)。结论:产ESBL的大肠杆菌和克雷伯氏杆菌的流行率较高，需要及时监测以有效管理这些耐多药菌株。

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来源期刊

Open Microbiology Journal Immunology and Microbiology-Immunology and Microbiology (all)

CiteScore

1.80

自引率

0.00%

发文量

期刊介绍： The Open Microbiology Journal is a peer-reviewed open access journal which publishes research articles, reviews/mini-reviews, case studies, guest edited thematic issues and short communications/letters covering theoretical and practical aspects of Microbial systematics, evolutionary microbiology, immunology, virology, parasitology , bacteriology, mycology, phycology, protozoology, microbial ecology, molecular biology, microbial physiology, biochemistry, microbial pathogenesis, host-microbe interaction, systems microbiology, synthetic microbiology, bioinformatics. The Open Microbiology Journal , a peer-reviewed journal, is an important and reliable source of current information on developments in the field. The emphasis will be on publishing quality papers rapidly and freely available to researchers worldwide.