Epidemiological Characteristics, Clinical Presentation, and Risk Factors Associated With Esbl Producing Uropathogens in Urinary Tract Infections at a Tertiary Care Centre

Priyanshi Priyanshi; Akhilesh Dubey; Kamini Savita; Praveen Kumar; Kailash Jatav

doi:10.37022/wjcmpr.v8i3.460

Authors

Priyanshi Ph.D. Scholar, Dept. of Microbiology, Index Medical College, Hospital & Research Centre, Malwanchal University, Indore, MP, India.
Akhilesh Dubey Assistant Professor, Dept. of Community Medicine, Mahabodhi Medical College Gaya Ji, Bihar.
Kamini Savita Senior Resident, Dept. of Biochemistry, S.N. Medical College, & Hospital, Agra, UP, India.
Praveen Kumar Ph.D. Scholar, Dept. of Botany, Patliputra University, Patna.
Kailash Jatav Associate Professor, Dept. of Microbiology, Index Medical College, Hospital & Research Centre, Malwanchal University, Indore, MP, India.

Abstract

Background: Urinary tract infections (UTIs) are common bacterial infections with variable epidemiological patterns, clinical presentations, and bacterial etiologies. Understanding these patterns is essential for accurate diagnosis and appropriate antimicrobial therapy.

Aim: To evaluate the epidemiological characteristics, clinical presentation, and risk factors associated with ESBL-producing uropathogens in patients with suspected UTIs.

Materials and Methods: A total of 400 urine samples were collected from patients with suspected UTIs. Samples were processed using standard microbiological techniques for bacterial isolation and identification. Demographic details, clinical manifestations, and relevant risk factors were documented. Antimicrobial susceptibility testing was performed using the Kirby–Bauer disk diffusion method.

Results: Of 400 urine samples, 304 (76.0%) showed significant bacterial growth, while 96 (24.0%) showed no significant growth. Females constituted 296 (74.0%) patients, and males accounted for 104 (26.0%). The predominant age group was 21–40 years (210; 52.5%). Most patients were outpatients (248; 62.0%), while 152 (38.0%) were hospitalized. Dysuria was the most common symptom (314; 78.5%), followed by increased urinary frequency or urgency (297; 74.2%), suprapubic pain (168; 42.0%), and fever (117; 29.2%). Among culture-positive samples, Enterobacteriaceae accounted for 258 (84.8%) isolates. Escherichia coli predominated (157; 60.9%), followed by Klebsiella pneumoniae (70; 27.1%), Proteus species (21; 8.1%), and Enterobacter species (10; 3.9%). Other isolates included Staphylococcus, Pseudomonas, and Enterococcus species.

Conclusion: Culture positivity was high, particularly among females and patients aged 21–40 years. Dysuria was the leading symptom, and E. coli was the predominant uropathogen. Routine urine culture, susceptibility testing, and local surveillance are essential for guiding appropriate treatment and antimicrobial stewardship.

Keywords:

Urinary tract infection, epidemiology, clinical presentation, urine culture, uropathogens, Escherichia coli, tertiary care center

DOI

https://doi.org/10.37022/wjcmpr.v8i3.460

References

1. Mohammed, A.B.; Anwar, K.A. Phenotypic and genotypic detection of extended spectrum beta lactamase enzyme in Klebsiella pneumoniae. PLoS ONE 2022, 17, e0267221.

2. Idrees, M.M.; Rasool, M.F.; Imran, I.; Khalid, A.; Saeed, A.; Ahmad, T.; Alqahtani, F. A Cross-Sectional Study to Evaluate Antimicrobial Susceptibility of Uropathogens from South Punjab, Pakistan. Infect. Drug Resist. 2022, 15, 1845–1855.

3. Rabaan, A.A.; Alhumaid, S.; Mutair, A.A.; Garout, M.; Abulhamayel, Y.; Halwani, M.A.; Alestad, J.H.; Bshabshe, A.A.; Sulaiman, T.; AlFonaisan, M.K. Application of Artificial Intelligence in Combating High Antimicrobial Resistance Rates. Antibiotics 2022 11, 784.

4. Is screening for antibiotic-resistant bacteria justified in the Indian context? J Med Microbiol. 2011;29(3):213–7.2.

5. Khalid, F.; Saleem, S.; Ahmad, I. High prevalence of carbapenem resistant Acinetobacter baumannii associated respiratory tract infections in Pakistani hospitals. J. Pak. Med. Assoc 2020, 70, 1630–1632.

6. Arumugam K, Karande GS, Patil SR. Prevalence of Carbapenemase Production Among Klebsiella and Escherichia coli Isolated from Urinary Tract Infections. Cureus. 2024;16(10):e70918. doi: 10.7759/ cureus.70918.

7. Tankhiwale SS, Jalgaonkar SV, Ahamad S, Hassani U. Evaluation of extended spectrum beta-lactamase in urinary isolates. Indian J Med Res. 2004;120(6):553 556.

8. Bhattacharya S. Is screening for antibiotic-resistant bacteria justified in the Indian context? J Med Microbiol. 2011;29(3):205–7.

9. Rabaan, A.A.; Alhumaid, S.; Mutair, A.A.; Garout, M.; Abulhamayel, Y.; Halwani, M.A.; Alestad, J.H.; Bshabshe, A.A.; Sulaiman, T.; Al Fonaisan, M.K. Application of Artificial Intelligence in Combating High Antimicrobial Resistance Rates. Antibiotics 2022, 11, 784.

10. Iovleva, A.; Doi, Y. Carbapenem-resistant enterobacteriaceae. Clin. Lab. Med. 2017, 37, 303–315.

11. Bradford PA. Extended-spectrum beta-lactamases in the 21st century: characterization, epidemiology, and detection of this important resistance threat. Clin Microbiol Rev. 2001; 14(4): 933-51. doi: 10.1128/cmr.14.4.933-951.2001, PMID: 11585791, PMCID: PMC89009.

12. Pitout JD, Laupland KB. Extended-spectrum beta-lactamase-producing Enterobacteriaceae: an emerging public-health concern. Lancet Infect Dis. 2008; 8(3): 159-66. doi: 10.1016/s1473-3099(08)70041-0, PMID: 18291338

13. Roh KH, Uh Y, Kim JS, Kim HS, Shin DH, Song W. First outbreak of multidrug-resistant Klebsiella pneumoniae producing both SHV-12-type extended-spectrum beta-lactamase and DHA-1-type AmpC beta lactamase at a Korean hospital. Yonsei Med J. 2008; 49(1): 53-7. doi: 10.3349/ymj.2008.49.1.53, PMID: 18306469, PMCID: PMC2615262.

14. Gouse Basha Sheik, Ahmed Sannat, Bader Al-Rowis, Sahar M. Jeddawy and Doaa M.Sherif. 2016. Prevalence, Risk Factors and Antimicrobial Susceptibility of Beta Lactamase Producing Enterobacteriacea in a 22 Tertiary Care Centre of Saudi Arabia. Int.J.Curr.Microbiol.App.Sci. 5(2): 98-109.

15. Muhammad Muqaddas Mustafai 1,2, Mavra Hafeez 3, Safa Munawar etal Prevalence of Carbapenemase and Extended-Spectrum-Lactamase Producing Enterobacteriaceae: A Cross-Sectional Study Antibiotics 2023, 12, 148.