Bacterial Resistance in Urinary Tract Infections: Multidrug Resistant ESBL Producing Gram Negative Uropathogens from Patients

Abstract

Urinary tract infection is one of the most common bacterial infectious diseases encountered in clinical practice. The development and spread of multidrug resistant isolates are of great global health burden; among them, extended spectrum beta-lactamase (ESBL) producing Enterobacteriaceae has been a prime concern. This topic describes the resistance patterns of eighty three (83) Gram negative uropathogens to different classes of antibiotics. Bacteria isolates were obtained from patients of all age groups who sought medical attention at a secondary and tertiary hospital in Northern Ghana. Culture and isolation methods employed were the quantitative urine culture on Cysteine Lysine Electrolyte Deficient (CLED) agar and standard biochemical tests. ESBL production was detected using the CLSI recommended phenotypic confirmatory test along with routine antibiotic susceptibility test, adopting the Kirby-Bauer disk diffusion method. Out of 83 isolates, seven (7) Gram negative uropathogens were characterized and ESBLs were detected in 32 of the isolates. Escherichia coli was the pathogen with most ESBL positive strains. Generally high and multiple drug resistance were recorded in both ESBL and non-ESBL strains to the empirical drugs, however, ESBL positive strains significantly (p = 0.000) showed greater resistance. A notable finding was the appreciable resistance exhibited by ESBL strains to last line treatment drugs that include aminoglycosides and imipenem.