UTIs continue to be the most prevalent bacterial infection in humans, even with the widespread availability of medications. Before the laboratory findings of urine culture and sensitivity are known, antibiotics are often administered empirically. Klebsiella species and E. coli are capable of producing enormous amounts of Extended Spectrum Beta Lactamases (ESBLs). The production of beta-lactamases is a significant issue in UTI. Oxyimino beta-lactams such as monobactam, ceftazidime, cefotaxime, and ceftriaxone are hydrolysed by enzymes known as ESBLs. ESBLs are resistant to a number of antibacterial substances. Maintaining current understanding of the organisms that cause UTIs and their drug susceptibility pattern is essential to ensuring optimal management. The best empirical treatment must be determined by continuously monitoring the local susceptibility patterns of uropathogens to new antimicrobials, as antibiotic resistance in a wide range of pathogenic organisms can fluctuate even for brief periods of time and can vary by geographic region. In order to determine the prevalence rate of UTI in patients with and without symptoms, as well as to analyse the range of uropathogens, the current study was conducted. For both indoor and outdoor UTI patients, a trend of antibiotic susceptibility was also seen. The findings indicated that girls had a considerably greater frequency of UTIs (about 70.30%) than boys. Both OPD and IPD patients had strong resistance patterns and significant ESBL production, as it was determined. In order to counteract the growing trend of antibiotic resistance in UTI infections, these data inform the doctors that they emphasise the need for updated antibiotic stewardship programs and the need of routine screening for ESBL development in clinical isolates.

Antibiotic, ESBLs (Extended Spectrum Beta Lactamase), OPD& IPD, UTI, Spectrum of Uropathogens

The current study examined the pattern of antimicrobial susceptibility in urine isolates, paying particular attention to those that generate Extended Spectrum Beta Lactamases (ESBLs) (Tonkic et al., 2005). There were 115 clinically suspected UTI cases in all. After the investigation was finished, the following results were made: Out of the 115 urine samples that were gathered for culture, 55 (47.82%) had significant bacteriuria, whereas 60 (52.7%) had questionable significant bacteriuria. Of the remaining 115 samples, 40 were sterile, 6 had non-significant bacteriuria, 4 had severe contamination, and 10 had Candida spp. growth. For the sake of the investigation, these were thus thrown away. It was discovered that the M:F ratio in 55 culture-positive cases was 1:1.2. The age range of 15–30 years old accounted for the greatest number of cases, encompassing both males (18) and girls (22). The age group of over 60 years old accounted for the smallest number of instances (15). Seventy instances came from the in-patient department, and forty-five cases were from the out-patient group. Of the 50 patients who had catheterisation, 32 (64%) had UTIs. Escherichia coli was the most prevalent urine pathogen in both in-patients (49.5%) and out-patients (53.3%). Citrobacter species, Klebsiella species, Enterobacter species, Acinetobacter species, Enterococcus species, Pseudomonas species, Proteus species, and Staphylococcus aureus were the next most frequent urinary pathogens, in that order. With the exception of Pseudomonas aeruginosa, the sensitivity pattern of Gram-negative bacilli revealed that amikacin, cefoperazone-sulbactam, and nitrofurantoin were extremely sensitive (64.1% to 88.8%) for both in-patients and out-patients; OPD isolates were more sensitive than IPD isolates. It was discovered that ampicillin, co-trimoxazole, and fluoroquinolones had very poor in vitro sensitivity (8.5% to 29.6%). The pattern of antibiotic susceptibility was not particular to any one bacterium. Pseudomonas aeruginosa isolates were all susceptible to cefpirome, piperacillin, meropenem, aztreonam, and piperacillin-tazobactam. Additionally, ceftazidime, amikacin, cefotaxime, and ceftazidime-clavulanic acid have demonstrated excellent susceptibility. Linezolid, vancomycin, and teicoplanin were all effective against the Gram-positive uropathogens (Pouladfar et al., 2017). There was just one Methicillin Resistant Staphylococcus aureus (MRSA) found in the patient cluster. E. coli produced ESBL in 47.82% of cases. Of the isolates in the in-patients, 63.3% were ESBL producers, compared to 36.6% in the out-patients. Therefore, a greater rate of ESBL synthesis was reported in the current investigation. Comparing E. coli that produced ESBL to those that did not, the former exhibited greater resistance to every antibiotic except cefoperazone-sulbactam, nitrofurantoin, and amikacin. Not a single isolate exhibited meropenem resistance. This trend was observed in both outpatients and inpatients. Indeed, this is a noteworthy discovery. Both OPD and IPD patients had a high resistance pattern and significant ESBL production, indicating that multidrug-resistant pathogens are widely distributed even within the population. In order to increase the organisms' susceptibility and ensure that the right antimicrobial drugs are chosen, urine culture and sensitivity must be made necessary. Therefore, the only way to stop bacterial infections from becoming more resistant is to utilise existing medicines sparingly and appropriately. This is a noteworthy discovery, no doubt. Both IPD and OPD patients exhibited significant ESBL production and a high resistance pattern, indicating that multidrug-resistant pathogens are widely distributed even within the population. Enforcing urine culture and sensitivity is necessary to increase organism susceptibility and ensure appropriate antimicrobial agent selection. The only way to prevent the growing resistance of bacterial infections is to utilise the existing antibiotics sparingly and appropriately.

Amit Kumar Gupta, Vivek Pratap Singh and Deepak Gupta (2025). Antimicrobial Sensitivity and Resistance in Urinary Isolates: ESBL Producers vs. Non-Producers. Biological Forum – An International Journal, 17(7): 220-226.