Prevalence of Ceftriaxone Resistance in Extended-Spectrum β-Lactamases in Multi-Drug Resistant Uropathogenic E. coli

Abstract

Multidrug resistant Uropathogenic Escherichia coli (UPEC) strains are responsible for the majority of urinary tract infections. Overall objective of this study was to scrutinize the prevalence of Ceftriaxone resistance among ESBL producer multidrug resistant isolates. In addition, screening of bla TEM gene was also carried out. In the present study, altogether 200 mid-stream urine samples were collected. Altogether, 155 bacterial isolates were confirmed by morphological, biochemical and molecular techniques. Antimicrobial disc diffusion reveals that out of 155 bacterial isolates77.5% were multidrug resistant (MDRs). In UPECs highest rate 82% of resistance was observed against Cephalothine followed by Cefotaxime 63.5% and Ceftriaxone 63.2%. Out of identified MDR, 37.4% of the isolate were ESBLs producers. All the ESBLs producers were screened for bla TEM gene and Minimum inhibitory concentrations (MICs) were measured by macro-broth dilution method. Majority of the resistant isolates 87% showed higher MICs for Ceftriaxone>256 μg/ml. MBCs measured for these samples were comparable to MICs. This report shows that presence of bla TEM gene among ESBLs producing MDR UPECs has 86% resistance to Ceftriaxone antibiotic. Among these resistant isolates, 95% of isolates have MICs >256ug/ml. The present study showed that bla TEM ESBLs production is more prevalent in our clinical E. coli isolates. It is concluded that due to high resistance of Ceftriaxone, it must be eliminated for the treatment of UTI caused by UPECs in potohar region specifically, further more in other regions it can be administered after performing antimicrobial sensitivity pattern by disc diffusion or MIC method.