Revista de la Facultad de Medicina (Jun 2022)
Prevalence of extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella pneumoniae isolates in outpatients with urinary tract infection in a Cuban municipality
Abstract
Introduction: Community-acquired urinary tract infections (CA-UTI) caused by extended-spectrum β-lactamases (ESBL)-producing Enterobacteriaceae are a growing phenomenon worldwide. Objective: To determine the prevalence of ESBL-producing Escherichia coli and Klebsiella pneumoniae isolates obtained from urine samples of outpatients with CA-UTI in a Cuban municipality, as well as the antibiotic resistance profiles associated with the ESBL phenotype. Materials and methods: Retrospective descriptive study. A total of 304 isolates of E. coli and 34 of K. pneumoniae obtained from urine cultures of patients with CA-UTI treated between January 1, 2019, and December 31, 2020, at the Hospital Clínico-Quirúrgico Docente Aleida Fernández Chardiet, in the municipality of Güines, Mayabeque province, Cuba, were analyzed. A bivariate analysis (chi-square test) was performed to determine differences in antibiotic resistance rates between ESBL-producing and non-producing bacteria. Results: 16.77% (51/304) and 17.64% (6/34) of E. coli and K. pneumoniae isolates were classified as ESBL-producing bacteria. In the case of ESBL-producing E. coli isolates, ESBL+ciprofloxacin was the most frequent antibiotic resistance pattern (22/51; 43.13%), followed by ESBL+ciprofloxacin and amikacin (14/51; 27.45%). Moreover, 41.17% (21/51) were multidrug-resistant. In the case of ESBL-producing K. pneumoniae, ESBL+ciprofloxacin, amikacin and nitrofurantoin was the predominant antimicrobial resistance pattern (2/6; 33.33%), and 50 % (3/6) were multidrug resistant. Conclusions: The results reported confirm the presence of ESLB-producing E. coli and K. pneumoniae, with a high prevalence of multidrug resistance in patients with CA-UTI in the municipality of Güines, Cuba.
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