Antimicrobial Resistance and Phenotypic Detection of Extended-Spectrum Beta-Lactamase in Entero bacteriaceae Isolated from Community-Acquired Urinary Tract Infections

Introduction: Urinary tract infections can affect all individuals, regardless of gender and age, occupying a prominent place in nephrological pathology. The major issue is that pathology with a wide range of antibiotics and other hygiene measures that can remedy it remains so frequent with sometimes serious complications that can compromise the vital prognosis. Extended-spectrum
-lactamases (ESBLs) are a group of diverse, complex, and rapidly evolving plasmid-mediated enzymes that today pose a major therapeutic challenge in the treatment of hospitalized and community patients.

Objectives: The primary objective of this study is to determine the antibiogram profile of enterobacteria in urinary infections. This study assesses the beta-lactam resistance and detects extended-spectrum beta-lactamase in Enterobacteriaceae isolated from community-acquired urinary tract infections.

Methodology: This is a cross-sectional study with an analytical aim of enterobacteria isolated from urinary infections from samples from patients of all ages from January 1, 2020, to October 21, 2022. Antimicrobial susceptibility testing for all enterobacteria was done using the Kirby-Bauer disk diffusion method according to Clinical Laboratory Standard Institute (CLSI) guidelines.

Results: The isolated enterobacteria strains presented high rates of resistance, i.e. 92.61% for Ampicillin, 47.94% for cefadroxil, 45.14% for cefuroxime, and 46.46% for cefotaxime, 72.86% for amoxicillin and 40.44% for amoxicillin + clavulanic acid. Qualitative detection of extended-spectrum Beta-Lactamase was generally evaluated at 24.8% with peaks for Citrobacter sp., Klebsiella sp., and E coli. For the latter, cross-resistance to quinolones was evaluated in proportions ranging from 49.45% to 85.51%.

Conclusion: This situation poses a significant public health challenge and highlights the urgent need to improve sanitation and implement antibiotic stewardship in developing countries. This study shows that the level of resistance of enterobacteria to beta-lactams is very high. We have observed co-resistance between beta-lactams and quinolones, antibiotics commonly used against Gram-negative bacteria. This observation requires an improvement in the antibiotic management policy.