Prevalence and Antibiotic Resistance Pattern of ESBL-Producing Escherichia coli in Urinary Tract Infections: A Hospital-Based Study

Abstract

Background: Extended-spectrum beta-lactamase (ESBL) producing Escherichia coli is an emerging cause of urinary tract infections (UTIs), limiting treatment options and posing a serious public health threat.

Objective: To determine the prevalence of ESBL-producing E. coli in urinary isolates and assess their antimicrobial resistance patterns.

Methods: A cross-sectional study was conducted over six months on 300 midstream urine samples from patients clinically suspected of UTIs. E. coli was identified using standard microbiological methods. ESBL production was screened using ceftazidime and cefotaxime discs and confirmed by phenotypic confirmatory disc diffusion test (PCDDT) as per CLSI 2012 guidelines. Antibiotic susceptibility testing was performed using the Kirby-Bauer disc diffusion method.

Results: Out of 300 urine samples, 128 (42.6%) yielded E. coli. Among these, 56 (43.7%) were confirmed as ESBL producers. High resistance was observed to third-generation cephalosporins and fluoroquinolones. Imipenem and nitrofurantoin retained good activity, with 94.6% and 82.1% susceptibility, respectively.

Conclusion: The prevalence of ESBL-producing E. coli in UTIs is alarmingly high. Routine screening for ESBL and rational antibiotic prescribing are necessary to curb the spread of multidrug-resistant organisms.

Keywords: ESBL, Escherichia coli, urinary tract infection, antibiotic resistance, PCDDT