Antibiotic Susceptibility Profile of Extended-Spectrum Beta-Lactamase in Escherichia Coli and Klebsiella Pneumonia from Urine Samples at Rwanda Military Hospital

Background: Extended-Spectrum Beta-Lactamase (ESBL) producing Escherichia coli and Klebsiella pneumoniae have emerged as significant pathogens in urinary tract infections (UTIs) due to their ability to resist commonly used antibiotics, leading to challenging treatment scenarios. Aim: This study aimed to determine the ESBL-producing E. coli and K. pneumonia and antibiotic susceptibility patterns of ESBL producing E. coli and K. pneumoniae isolates obtained from patients with UTI and to evaluate the effectiveness of various antibiotics against these bacteria. Methods: This study used retrospective method to determine the ESBL-producing E. coli and K. pneumonia and antibiotic susceptibility patterns of ESBL producing E. coli and K. pneumoniae isolates obtained from patients with UTI and to evaluate the effectiveness of various antibiotics against these bacteria. Results: The findings from this study revealed a higher frequency of ESBL-producing E. coli and K. pneumoniae in males (58%) than in females (42%). Specifically, E. coli accounted for 82% of the ESBL-producing isolates, while K. pneumoniae represented 18%. This study found that antibiotics such as Cefotaxime, Ceftazidime, and Ceftriaxone were notably less effective against UTIs caused by these bacteria. The resistance rates to Cefotaxime, Ceftazidime, and Ceftriaxone were 92%, 93%, and 94% for E. coli, and 78%, 83%, and 92% for K. pneumoniae, respectively. This underscores the growing ineffectiveness of these beta-lactam antibiotics in treating infections caused by ESBL-producing strains. Conversely, this study observed that Meropenem and Piperacillin-Tazobactam exhibited relatively higher efficacy. Specifically, Meropenem was effective in 65% of E. coli and 62% of K. pneumoniae infections, while Piperacillin-Tazobactam was effective in 71% of E. coli and 50% of K. pneumoniae infections. These results are crucial for guiding empirical therapy and tailoring treatment regimens for UTIs caused by ESBL-producing bacteria. Given the high prevalence of resistance to third and fourth generation beta-lactam antibiotics, the findings from this study emphasize the need for ongoing surveillance of antibiotic susceptibility patterns and the prudent use of Meropenem and Piperacillin-Tazobactam to manage infections effectively. Additionally, higher prevalence in males could suggest gender-based differences in susceptibility or access to healthcare, warranting further investigation to understand the underlying factors contributing to these discrepancies.