Phenotypic detection of Extended Spectrum β-Lactamases (ESBL) among gram negative uropathogens reveals highly susceptibility to imipenem

Objective: We aimed to determine antibiotic susceptibility patterns of ESBL- and non-ESBL bacteria isolated from pregnant women with UTI in antenatal wards in Khartoum State, Sudan. Methods: This cross-sectional study was conducted during April-July 2016 at different hospitals in Khartoum State. Mid-stream urine samples were obtained from 150 hospitalized pregnant women and cultured on CLED (Cystine Lactose Electrolyte Deficient) agar. Microorganisms were identified using standard microbiological procedures. Isolated Gram-negative bacteria were tested for antibiotic susceptibility and ESBL screening using modified Kirby- Bauer method and Double Disc Synergy Test (DDST) respectively. Results: Urine culture revealed positive results in 33/150 (22%) and the most prevalent isolates were Gram negative bacteria (18/33, 54.5%). Among gram-negative bacteria, isolates of E. coli were the most prevalent accounting 66.6% (12/18) followed by K. pneumoniae (4/18, 22.2%) and K. oxytoca (2/18, 11.1%). ESBL was detected in 8/18 (44.4%) of the Gram-negative isolates. Of note, imipenem was the most susceptible antibiotic for ESBL-producer and non-ESBL producer Gram negative isolates, accounting 100% susceptibility for both bacterial groups. Overall susceptibility rates were also high for ciprofloxacin (13/18, 72.2%). In other hand, co-trimoxazole and amoxicillin showed high resistance pattern for ESBL-producer and non-ESBL producer isolates; 27.8%, 44.4% and 38.9%, 38.9% susceptibility rates of co-trimoxazole and amoxicillin for ESBL-producer and non-ESBL producer isolates, respectively. Conclusions: Imipenem remains the most powerful option for ESBL- and non-ESBL bacteria causing UTIs in pregnant women. However, due to tremendous increase of antibiotic-resistant, antibiotic-susceptibility testing is recommended as a routine investigation for admitted pregnant women. doi: doi.org How to cite this:Mohammed I, Abass E. Phenotypic detection of Extended Spectrum β-Lactamases (ESBL) among gram negative uropathogens reveals highly susceptibility to imipenem. Pak J Med Sci. 2019;35(4):1104-1109. doi: doi.org This is an Open Access article distributed under the terms of the Creative Commons Attribution License (creativecommons.org), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.