Study Of Antimicrobial Resistance And Antibiotic Sensitivity Patterns Among Urinary Isolates With Esbl Producers

Abstract

Background: Urinary tract infections (UTIs) are among the most common bacterial infections worldwide. The emergence of Extended Spectrum Beta-Lactamase (ESBL)-producing organisms has become a major challenge due to their multidrug-resistant nature and limited treatment options.

Objective: To determine the prevalence of ESBL-producing urinary isolates and evaluate their antimicrobial susceptibility patterns among patients with urinary tract infections.

Materials and Methods: A cross-sectional study was conducted from March 2023 to May 2024. A total of 230 urine samples were collected from outpatient and inpatient departments of Kidney Stone Hospital, Prayagraj. Samples were processed using standard microbiological methods. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disc diffusion method according to CLSI guidelines. ESBL production was confirmed using the Phenotypic Confirmatory Disc Diffusion Test.

Results: Among 230 urine samples, 197 showed significant bacterial growth. Gram-negative bacilli constituted 95.4% of isolates. Escherichia coli was the predominant pathogen followed by Citrobacter spp. and Klebsiella spp. High susceptibility was observed towards amikacin, nitrofurantoin, cefoperazone-sulbactam and meropenem. ESBL production was detected in 54.4% (56/103) of E. coli and 55% (11/20)of Klebsiella spp. isolates. ESBL-producing organisms exhibited significantly higher resistance to commonly used antibiotics compared to non-ESBL producers.

Conclusion: The study demonstrated a high prevalence of ESBL-producing urinary pathogens with increased resistance to commonly used antibiotics. Amikacin, nitrofurantoin, cefoperazone-sulbactam, and meropenem showed the highest antimicrobial activity. Regular surveillance of antimicrobial susceptibility patterns is important to support appropriate antibiotic therapy.