Prevalence and antibiotic susceptibility patterns of extended spectrum β-lactamase producing Escherichia coli in urine samples obtained from patients admitted at Mbale regional referral hospital
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Extended Spectrum Beta-lactamase-producing bacteria such as E. coli has become an emerging global health threat and are associated with high mortality. Production of Beta lactamase enzymes that hydrolyze the β-lactam ring is a major resistance mechanism for several Gram-negative bacteria including Enterobacteriaceae such as E. coli, K. pneumoniae, K. oxytoca, P. aeruginosa among others. This cross-sectional study was conducted at Mbale Regional Referral Hospital between January and April, 2020 to determine the prevalence of Extended Spectrum Beta-lactamase- producing E. coli in urine samples obtained from patients admitted at Mbale Regional Referral Hospital and the antibiotic susceptibility patterns of Extended Spectrum Beta-lactamase- producing E. coli to commonly used antibiotics in clinical management to bacterial infections related to E. coli. Sampling was done from the different hospital wards, a total of 100 samples were collected and tested for production of Extended Spectrum Beta-lactamase using antibiotic testing. Results showed 100% resistance and 0% susceptibility to both Tetracycline and Ampicillin whereas Ciprofloxacin had 66% susceptibility and 34% resistance, Nalidixic acid had 60% susceptibility and 40% resistance, and Gentamycin had 60% susceptibility and 40% resistance. The results also showed that the prevalence of Extended Spectrum Beta-lactamase producing E. coli was 25% (n = 100) when using both Cefotaxime-Clavulanic acid combination and Ceftazidime-Clavulanic acid combination. This study revealed a moderate prevalence of Extended Spectrum Beta-lactamase producing E. coli from Mbale Regional Referral Hospital and high levels of resistance to third generation cephalosporins specifically Ceftazidime and Cefotaxime. In addition to undertaking appropriate infection control measures, there is urgent need for formulation of an antibiotic policy in Uganda to prevent spread of these organisms. This also calls for continuous monitoring and reporting of the presence of such organisms in order to ensure rational and judicious use of antibiotics by clinicians.