Detection of ESBL genes from ciprofloxacin resistant Gram negative bacteria isolated from urinary tract infections (UTIs)

Abstract

Urinary tract infections (UTIs) are the most disregarded diseases in both developing and developed countries and accountable for one fourth of the health care related infections. Even though the women and children are the most susceptible reservoir, the infections are at a significant amount in men of all ages. In UTI, the multidrug resistant bacteria (MDRB) is an emerging burden and now represents a daily challenge for the management of antimicrobial therapy in healthcare settings. A total of 100 uropathogens of Gram negative bacteria (GNB) were used in the current study to detect the ciprofloxacin resistant effect due to extended spectrum beta lactameses production (ESBLs). The phenotypic identification of ESBLs producing uropathogens from UTIs were detected by primary ESBL identification test (PMIT) and double disc combination method (DDCM). In addition, the ESBL production was further confirmed by MIC stripe method. Further, the prevalence of TEM, SHV, OXA and CTX-M type genes of isolated GNB and ciprofloxacin resistant strains was detected by multiplex PCR method. Among the 100 uropathogens, 84% was found to produce ESBLs. Out of 84, 60 strains were identified as ciprofloxacin resistant by Hexa discs and they developed resistance against all antibiotics. The PMIT and DDCM proved the result including Escherichia coli (26), 21 isolates of Proteusmirabilis, 17 of Pseudomonas aeruginosa, 14 of Klebsiellapneumoniae and 6 of Acinetobacter sp. In particular, the high number of CTX-M and TEM genes were frequently detected from collected uropathogens and all the TEM, SHV, OXA, and CTX-M genes were identified from ciprofloxacin resistant strains only. Due to the increase of multiple ESBL genes in uropathogens, sustained supervision for using favorable antibiotics and the decreasing the infection is essential.