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Extended Spectrum Beta Lactamase and Metallo Beta lactamase Producing Escherichia coli isolated from Urine Sample in Tertiary Care Hospital of Damak, Nepal

  • Bijay Kumar Shrestha
  • Anu Rai
  • Jenish Shakya
  • Hemanta Khanal
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Bijay Kumar Shrestha, Anu Rai, Jenish Shakya, & Hemanta Khanal. (2019). Extended Spectrum Beta Lactamase and Metallo Beta lactamase Producing Escherichia coli isolated from Urine Sample in Tertiary Care Hospital of Damak, Nepal . Journal of Medical Biomedical and Applied Sciences, 7(12), 312–319. https://doi.org/10.15520/jmbas.v7i12.206
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Abstract

Background: Antibiotic resistance among uropathogens is emerging public health problem. The predominant etiology agent of UTIs is E. coli.Nowadays, resistance power of the organism is developing which may be innately acquired during their lifecycle.The emergence of beta–lactamase and metallo-beta-lactamase is an important mechanism that makes bacteria more resistant to antibiotics as these enzymes hydrolyze the antibiotics.
Objective: The main focus of this study is to isolate the E. coli following the antibiotic sensitivity test to some drugs and detecting ESBLs and MBLs producing E. coli from the urine specimens by combined disc diffusion method.
Method:This research was held in life-line hospital, Damak where patients were included from the inpatient department and outpatient department. This cross-sectional study was carried for six month. TheStandard microbiological procedures were used for isolation and identification of uropathogens. The antimicrobial susceptibility pattern of bacterial isolates was determined by Kirby-Bauer Disc Diffusion method. The E. coli isolates were screened for ESBL, MBL by combined disc diffusion test. The p-value<0.05 was considered statistically significant.
Result: Total 101E. coli was isolated from 510 urine samples and antibiotic sensitivity pattern was performed by Kirby Bauer disc diffusion method according to CLSI. The prevalence of E coliwas 19.80 % in study population and the prevalence of MDR was 45.54% among the bacterial isolates. The bacteria developed resistance to almost all antibiotics including cephalosporin, imipenem, and ciprofloxacin which was signing towards MDR. The phenotypic method was followed to detect the ESBL (44.55%) and MBL (39.60%) enzymes of E. coli. Both ESBL and MBL positive isolates were 19.80% from the study
Conclusion: The emerging drug resistance among ESBL and MBL producers reflects the indiscriminate use of antibioticsthat raises difficulties in clinical therapeutic options in hospital as well in community. So, proper microbiological analysis of pathogenic isolates and use of selective antibiotics can reduce the emergence of resistant strains.

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