Community and hospital-acquired urinary tract infections with gram-negative bacteria cause of extended spectrum β-laktamase (ESBL) activity and comparison of various antibiotic resistance patterns

Urınary tract infections are in first place in the infections. Urınary tract infections are caused by the most common Enterobacteriaceae family and expended-spectrum β-lactamase (ESBL) is increasing in these strains. In our study 7,500 urine specimens were collected between 1.10.2015 -3.3.2016 and colony formation was detected in 1478(19,7%) of them. Of these, 1172 (79.3%) were Gram negative and 306 (20.7%) belonged to Gram positive bacteria. The most common isolated bacteria were E. coli (45,9%), Klebsiella spp (14,9%), Pseudomonas spp. (7,9%) and Proteus spp. (3,78%). ESBL positivity were found in 400 of E. coli (59.0%) and 129 of K. pneumoniae strains (60.8%) by Vitek 2 system. In E. coli and K. pneumoniae strains ESLB positivity were 67,2% and 62,9% in service and policlinics respectively. Compatibility of Vitek 2 and DDST were 94.5% and also compability in E. coli were 99.8% and in K. pneumoniae were 100% between Vitek 2 and Chrom ID in terms of ESBL positivity. When we look at resistance,100%ampicilin resistance was observed in policlinic and service in E. coli ESBL positive strains. Respectively, 91,2% and 91,3% for cefuroxime, again respectively, 90,2% and 96,1% resistance was observed in ceftriaxone. The highest sensitivity in ESBL-producing E. coli was found in the carbapenem group with96,3- 98,15% in policlinic and 83,7-96,8% in service. The highest resistance in ESBL positive K. pneumoniae in service and policlinics was seen 100% for ampicillin. The most effective antibiotics were carbapenem group with 73,8-77% in policlinics and 69,2-82,4% in services for ESBL positive. In ESBL negative cases, it was also observed in the carbapenem group with 100% in policlinics and 95.0-97.5% in services. Amikacin was remarkably sensitive with 77.9% in ESBL-positive K. pneumoniae isolates from the services,