High MDR and ESBL Producing Escherichia coli and Klesbiella pneumoniae from Urine, Pus and Sputum Samples

Aims: This study was done to assess the prevalence of multidrug resistance and extended spectrum β-lactamase producing E. coli, K. pneumoniae in urine, pus and sputum.

Place and Duration of Study: This study was done to assess the prevalence of MDR and ESBL producing E. coli and Klebsiella in urine, pus and sputum from March 2013 to April 2014 at KIST Medical College, Lalitpur, kathmandu, Nepal.

Methodology: E. coli and K. pneumoniae were isolated from urine, pus and sputum samples in KIST Medical College, Lalitpur, Nepal. Antibiotic susceptibility test was performed by using disk diffusion method. MDR isolates which were suspected as ESBL producers were confirmed by using double disk synergy test and combined disk diffusion test for same isolates.

Results: Out of 580 urine samples, (87/580) 15% showed significant growth of E. coli and K. pneumoniae while in 97 pus and 124 sputum (16/221) 7% showed significant growth of E. coli and K. pneumoniae. From the sputum among 9 isolates, 3 were E. coli and 6 were K. pneumoniae whereas in pus among 7 isolates, 6 were E. coli and one was K. pneumoniae. Out of E. coli (77) isolates from urine, (74/77) 96.10% were MDR and of K. pneumoniae (10) isolates from urine 90% were MDR. Among E. coli (74) MDR isolates 52/74 (70.27%) were ESBL producers whereas all MDR K. pneumoniae isolates from urine were ESBL producers. All the isolates of E. coli and K. pneumoniae from pus and sputum were MDR which were resistant to tested third generation cephalosporins. Among the isolates E. coli (55.55%) and K. pneumoniae (42.85%) isolates were ESBL producers.

Conclusions: The high prevalence of MDR E. coli and K. pneumoniae was observed in urine, pus and sputum. The resistance pattern was alarmingly higher to all the antibiotics used except imipenem and amikacin. The prevalence of ESBL was higher so necessary step should be taken to prevent the spread and emergence of resistance.