Molecular Epidemiology and Characterisation of Extended Spectrum Beta Lactamase Producing E. coli in Female Patients with Urinary Tract Infection

Abstract

Background: Urinary tract infections form the common community and hospital acquired- infection in Iraq, with impact on health care delivery. The emergence of antimicrobial resistance which increased in its prevalence with time attributed the treatment failure and recurrent infection. Aim: The aim of this study was determine the prevalence of extended spectrum beta lactamase and ESBL resistance genes of E. coli in female in Kirkuk city.
Materials and Methods: A prospective cross-sectional study was conducted during the period from 1st of June 2015 to the end of January 2016. The study included in the study is 563 women, of them 425 (75.5%) were outpatients and 138 (24.5%) were inpatients. Their age range between 18 and 80 years, with a mean age of 33.59±15.29 years. Bacteria isolation, identification and ESBL production were performed using conventional methods. Polymerase chain reaction was used to determine ESBL genes in E. coli with extended spectrum beta lactamase production.
Results: The overall infection rate in our study cohort was 41.6% and E. coli was the predominant isolate which form 57.7% of the positive culture. Gram negative bacteria were the predominant cause of urinary tract infection and form 82.5%, while gram
positive bacteria isolated form 17.5% of cases. E. coli isolates were highly susceptible to imipenem, amikacin and nitrofurantoin, while demonstrated resistance rate of 87.4% to ampicillin, and 79.3% to amoxicillin, and a rate of 53.3% - 85.2% to 3rd generation cephalosporins and 25.2% to 69.6% to quinolones.