European Journal of Cardiovascular Medicine

Background:  Ventilator Associated Pneumonia (VAP) is one of the common nosocomial infections associated with high morbidity due to multidrug resistant pathogens. Rapid spread of resistance to broad spectrum beta-lactams in pathogenic strains causes antibiotics ineffectiveness and increased severity of illness. The CTX-M is the most dominant Extended Spectrum β Lactamase (ESBL) among Enterobacteriaceae in many regions of the world. The aim of the study was to identify the occurrence of ESBL. Materials and methods: This prospective study was conducted in the Department of Microbiology, Shadan Institute of Medical Sciences Teaching Hospital and Research Center. A total of 300 consecutive urine samples were screened from patients with symptomatic UTI. Clean-catch midstream urine samples were collected in sterile disposable container and processed within one hour. Semi quantitative loop measuring 2.2 mm diameter with a holding capacity of 0.005 ml was employed to culture urine on CLED agar and MacConkey’s agar. The inoculated plates were incubated over night at 37oC. Isolates in significant number (colony count ≥ 105 CFU/ml) was identified by standard procedures. Results: In our study high susceptibility of meropenem (74.3%) and imipenem (100%) was seen and least was  Ciprofloxacin 41.4%. Double disc synergy test and Inhibitory potentiated disc diffusion Test screening test for ESBL production, 70 (43.7%) isolates were resistant to at least one of the three representative cephalosporin drugs. The highest resistance was observed with cefpodoxime (n=57; 40.1%) followed by ceftazidime (n=52; 37.9%) and cefotaxime (n=39; 28.4%). Out of the three cephalosporins tested in the study, ceftazidime was found to be the better antibiotic drug for the identification of ESBL production by both Double disc synergy test and Inhibitory potentiated disc diffusion Test. Conclusion: This study showed that the ESBL‑positive isolates were more resistant to some first‑line antibiotics, and this highlights the necessity to control and monitor the prescribed antibiotics used for empirical treatment for UTI patients.