Phenotypic Detection of Extended Spectrum Beta Lactamase in Uropathogens Among Pregnant Women Attending Antenatal Care in Alert Hospital, Addis Ababa, Ethiopia.
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Date
2019-03
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Addis Ababa University
Abstract
Background: Nowadays magnitude of Extended Spectrum β- Lactamases (ESBL) producing bacteria which cause urinary tract infection is the most worrying issue in the world. The occurrence of ESBL producers especially in pregnant women can result in life threatening condition and morbidity for both the mother and the newborn due to unavailability of diagnostic method and very limited drug options for treatment of these pathogens in our country. Therefore, evidence regarding the magnitude of ESBL producers among pregnant women is demanding.
Objectives: To determine Extended Spectrum Beta Lactamase in uropathogens and antimicrobial susceptibility pattern of Gram negative bacilli isolates among pregnant women attending antenatal care in ALERT hospital, Addis Ababa, Ethiopia.
Methods: A cross sectional study was conducted from July to September 2018 on a total of 177 pregnant women with and without symptoms of urinary tract infection at ALERT hospital, Addis Ababa, Ethiopia. All urine samples were inoculated onto Cysteine Lactose Electrolyte Deficient
medium (CLED) and MacCkonkey agar. Colonies were counted to check the presence of significant bacteriuria. Pure isolates of bacterial pathogen were characterized and identified at species level by colony morphology, gram-stain and standard biochemical procedures. All Gram negative isolates were put into Muller-Hinton agar plates for antibiotic susceptibility test by Kirby-Bauer disc diffusion technique. ESBL was detected using double disk synergy methods on Muller Hinton agar. The data were double entered into EPI INFO and analyzed using Statistical Package for Social Science (SPSS) version 26.
Results: The overall prevalence of UTI among pregnant women was 14.7% (n=26/177). K. pneumoniae was the predominant bacterial etiologic agent of UTI (26.9% (n=7/26)). The prevalence of ESBL among gram negative isolates was 50% (n=6/12). Among ESBL producing isolates all (100%) were resistance to Amikacin, Gentamicin and Ceftriaxone while intermediate level resistance rate of 66.7% was observed among Trimethoprim sulphamethoxazole and Cefixime. They were susceptible for some limited drugs and these were Nitrofurantoin (83.3%) and Chloramphenicol (83.3%).
Conclusions:- Majority of ESBL producing isolates exhibited co-resistance to other commonly prescribed antibiotics. This indicates that the option of treatment for these pathogens rapidly decreased from time to time which results serous life threating conditions especially in mother and newborn unless the appropriate measure is taken.
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Extended spectrum beta lactamases, Antibiotic resistance, Uropathogen, Pregnancy, Urinary tract infection, Addis Ababa, Ethiopia