Extended-spectrum beta-lactamase and Antibiotic susceptibility pattern in uropathogens.

Abstract

Objective: To identify rapidly changing antibiotic susceptibility of ESBL & Uropathogens. Study Design: Comparative Cross-sectional prospective study. Setting:  Allied Hospitals of Peshawar Medical College. Period: 8^th November 2021 to 5^th March 2022. Material & Methods: 10-15ml of midstream urine was collected in a sterile container from 158 patients Pus cells, red blood cells, and bacteria were examined using microscopy. The standard loop technique was used to inoculate urine specimen on MacConkey and Blood agar. Plates were incubated for 24 hours at 37^oC. A colony count of 10⁵ cfu/ml was thought to be significant. Gram staining of the colonies was performed. The biochemical tests were conducted on API 10S for the identification of organisms. Extended-spectrum beta-lactamase organisms were identified by the double-disc synergy method. The Kirby-Bauer disc diffusion method was used to test antibiotic susceptibility on Mueller-Hinton agar according to CLSI guidelines 2021. A statistical package for the social sciences (SPSS) version 20.0 was used for statistical analysis. Results: Out of 158 urine samples 135 (85.5%) had positive culture growth with 35 (25.9%) ESBL confirmed. Antibiotic susceptibility was Nitrofurantoin (70.1%), Trimethoprim-sulfamethoxazole (26.8%), Ciprofloxacin (51.5%), Levofloxacin (51.5%), Ceftriaxone (25.77%) Cefotaxime (23.7%) Ceftazidime (19.5%) Cefepime (27.8%) Aztreonam (2.1%) Meropenem (86.6%) Amoxicillin/clavulanic (37.1%) Gentamycin (73%) Penicillin (0%). Conclusion: Surprisingly, only nitrofurantoin was found to be advised orally as a suitable drug for the treatment of UTIs among the 13 commonly used antibiotics.