Epidemiology of Extended Spectrum B-Lactamase Producing Gram Negative Bacilli of Community Acquired Urinary Tract Infection in Tabriz, Iran

Abstract

Bacteria which produce extended spectrum beta-lactamase (ESBLs) are resistant to all kinds of beta-lactam antibiotics and may also induce resistance to some other antibiotics including aminoglycosides, quinolones and trimethoprim-sulfamathoxazoles. Infection with these bacteria is very crucial among patients with urinary tract infection. In this study urine samples were collected from all administered patients who were clinically diagnosed with urinary tract infection and had positive urinary analysis. The urine samples of these patients undergone bacteriological tests for ESBL producing gram negative bacilii. Among 893 patients, 763 met the inclusion criteria and entered the study. A total of 587 samples of these patients were positive for four gram negative studied bacilli. The urine samples of 106 individuals (49 male (46%) and 61 female (54%) with mean age of 61 (Range: 19-90) years) were positive to extended spectrum beta-lactamase producing bacteria. All isolates were susceptible to colistin and resistant to cefotaxime, ceftriaxone and cephalotine. The rate of resistance to Tazobactam as a beta-lactam antibiotic was relatively low. Enterobacter and Cirobacter had the highest multi drug resistance (MDR). In conclusion the prevalence of infection with ESBLs producing gram negative bacilli in patients with community acquired urinary tract infection (CA-UTI) relatively high in our sampled population. The antibiogram test suggest that colistin is an appropriate antibiotic for these patients, and tazobactam is the most efficient beta-lactam antibiotic in this case. However it would be preferable to carry out antibiogram test for high risk patients.