Urinary tract infections due to Amp C b-Lactamase producing gram negative bacteria

Abstract

Introduction: The exact occurrence of extended spectrum β-lactamase (ESBL) and AmpC β -lactamase production among uropathogenic bacteria is not known. Infections with drug resistant urinary pathogens have limited therapeutic options. Hence this study was conducted to know the occurrence of AmpC β-lactamase production among gram negative bacteria (GNB) causing urinary tract infection (UTI). Materials and Methods : The urine samples submitted to Department of Microbiology from 1st March 2016 to 30th April 2016 were studied. All the samples were plated on sheep blood agar and MacConkey's agar. The isolates were identified and Antibiotic susceptibility testing was done. AmpC β -lactamase and ESBL detection was done as described previously. The results were tabulated. Results: This study was conducted on 900 urine samples. Total 144 (16%) GNB were isolated. E coli was the most common isolate followed by non-fermenting gram negative bacteria (NFGNB). AmpC β -lactamase production was seen in 75 (52.1%) isolates and ESBL production was seen in 60 isolates (41.7%). Total 27 (18.7%) isolates showed multidrug resistant (MDR) phenotypes and 23/27 were AmpC β -lactamase producers. Conclusion: Routine detection of ESBL and AmpC β -lactamase is required to choose appropriate therapy. Judicious use of antibiotics should be done in clinical settings. Imipenem can be used as an empirical antibiotic for complicated urinary tract infection.