RESEARCH ARTICLE


Extended Spectrum Beta-Lactamase Production in Uropathogens Isolated from Hospitalized Patients with Chronic Pyelonephritis



Olga I Chub*, 1, Aleksandr V Bilchenko 1, Igor Khalin 2
1 Kharkiv Medical Academy for Postgraduate Education, Ukraine
2 National Defense University of Malaysia, Faculty of Medicine and Defense Health, Malaysia


Article Metrics

CrossRef Citations:
2
Total Statistics:

Full-Text HTML Views: 4335
Abstract HTML Views: 2513
PDF Downloads: 1049
ePub Downloads: 729
Total Views/Downloads: 8626
Unique Statistics:

Full-Text HTML Views: 1722
Abstract HTML Views: 1236
PDF Downloads: 697
ePub Downloads: 486
Total Views/Downloads: 4141



Creative Commons License
© Chub et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Kharkiv Medical Academy for Postgraduate Education, Ukraine; Tel: +380953545759; Fax: +3 (8057) 711-80-25; Email: o.chub@mail.ru


Abstract

Background :

Increased multidrug resistance of extended-spectrum beta-lactamases (ESBLs) compromises the efficacy of treatment of urinary tract infections.

Objective :

The objective of this study is to determine the prevalence of ESBL-producing uropathogens from hospitalized patients with chronic pyelonephritis and to identify the presence of genes involved in the resistance.

Methods :

A cross-sectional study of 105 patients with chronic pyelonephritis, treated in Kharkiv City Clinical Emergency Hospital, Ukraine was carried. Bacterial isolates were collected, antimicrobial susceptibility of isolates was determined by the Kirby Bauer disk diffusion method and screening for the presence of blaSHV, blaTEM, blaCTX-M ESBL genes was performed by polymerase chain reaction.

Results :

84 (80%) patients had positive urine cultures. Eschеrichia coli wаs the most common microorganism isolated. Among them, 29 (25.2%) were found to be ESBL producers. Out of 53 E. coli isolates, 10 (18.9%), 4 (7.5%) and 6 (11.3%) were identified to carry bla(TEM), bla(SHV) and bla(CTX-M) beta-lactamase genes, respectively. The highest resistance was observed against ampicillin (75.9%), ciprofloxacin (48.3%), levofloxacin (41.4%) and gentamicin (41.4%). Beside this, only meropenem (96.6% susceptibility), nitroxolinum (86.2%) and fosfomycin (72.4%) exhibited a good enough activity against ESBLs-producing urinary strains.

Conclusion :

Isоlation and detеction of ESBL-prоducing strаins are еssential fоr the sеlection оf the mоst effеctive antibiоtic for the empiric trеatment.

Keywords: Beta-lactams, chronic pyelonephritis, extended-spectrum beta-lactamases, plasmids, resistance.