Investigation of Antibiotic Resistance and ESBL-Presence of CommunityAcquired Escherichia Coli Strains, Isolated from UTI in Afşin State Hospital

Abstract

Escherichia coli is the most common microorganisms isolated from community-acquired urinary tract infections (UTIs). Furthermore increasing frequency of extended spectrum β-lactamase (ESBL) positive E. coli strains in community-acquired UTIs has led to increasing rates of resistance to antibiotics that used in empirical treatment. The aim of this study was to determine the antimicrobial resistance patterns and epidemiological characteristics of community-acquired E.coli strains in our geographical region. The 3887 (2146 women and 1741 men) urine culture samples examined between September 2011 - September 2013 which were sent to microbiology laboratory from outpatient clinics of our hospital with a preliminary diagnosis of UTIs. 697 (18%) of urine culture samples were find positive; 423 (61%) were female, 274 (39%) were male. By using conventional methods, 352(51%) of the isolated strains were identified as E.coli. Antimicrobial susceptibilities of E.coli strains determined by Clinical Laboratory Standards Institute criteria. Extended spectrum β-lactamase was investigated by double-disk synergy test. The 352 isolated strains of E.coli belong to 47% of urology, 28% of internal medicine and 25% of pediatric patients urine cultures. The highest resistance ratio was observed against to ampicillin according to 68% treatments.  There was no resistance found against imipenem and amikacin and 2% of resistance determined to fosfomycin trometamol. The 53 (15%) of isolated strains had extended spectrum β-lactamase. Determination of the antimicrobial resistance rates and selection of the empirical treatment according to these results will prevent the ESBL production and development of resistance to antimicrobials in our region. Also, we hope this study will help to determine the differences between similar geographical regional studies and comparing the results.