Beta Lactamase Producing Escherichia coli, Klebsiella pneumoniae and Methicillin Resistant Staphylococcus aureus among Uropathogens

Abstract

Urinary tract infection (UTI) is the leading cause of morbidity and health care expenditures in persons of all the ages. The impact of disease is high in the low-resource developing countries due to lack of awareness about the UTIs caused by extended spectrum beta lactamase producing pathogens and methicillin resistant Staphylococcus aureus. This study represents a cross-sectional analysis of UTI prevalence in patients attending at KIST Medical College Teaching Hospital, Imadole, Lalitpur. Bacterial isolates were identified using standard biochemical tests. The antimicrobial susceptibility to various drugs and confirmation of the extended spectrum ß-lactamase (ESBL) and methicillin resistant Staphylococcus aureus (MRSA) production was done following Clinical & Laboratory Standards Institute (CLSI) guidelines. During the study period, 303 (24.08% of urine submissions) UTIs were confirmed. Among these 303 strains, E. coli was the most common, representing 65.34% of the isolates, followed by S. aureus (6.93%) and other pathogens (27.72%). Prevalence of ESBL E. coli, K. pneumoniae and MRSA in the urinary isolates were found to be 38.38 %, 35 % and 47.61 % respectively. Empiric treatment for UTIs in Nepal should be reconsidered and prudent use of antibiotics, particularly Gentamycin, is highly recommended. The recent spread of ESBL-producing Enterobacteriaceae and MRSA is striking and underlines the need for further studies.

Nepal Journal of Science and Technology Vol. 16, No.1 (2015) pp.105-112