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Extended-spectrum ß-Lactamase-producing Enterobacteriaceae as a Common Cause of Urinary Tract Infections in Sri Lanka.

Publication ,  Journal Article
Tillekeratne, LG; Vidanagama, D; Tippalagama, R; Lewkebandara, R; Joyce, M; Nicholson, BP; Nagahawatte, A; Bodinayake, CK; De Silva, AD; Woods, CW
Published in: Infect Chemother
September 2016

BACKGROUND: Extended-spectrum ß-lactamase-producing Enterobacteriaceae (ESBL-PE) are increasingly reported as pathogens in urinary tract infections (UTIs). However, in Sri Lanka, the clinical and molecular epidemiology of ESBL-PE implicated in UTIs has not been well described. MATERIALS AND METHODS: We conducted prospective, laboratory-based surveillance from October to December 2013 at a tertiary care hospital in southern Sri Lanka and enrolled patients ≥1 year of age with clinically relevant UTIs due to ESBL-PE. Isolate identity, antimicrobial drug susceptibility, and ESBL production were determined. Presence of ß-lactamase genes, bla(SHV), bla(TEM), and bla(CTX-M), was identified by polymerase chain reaction. RESULTS: During the study period, Enterobacteriaceae were detected in 184 urine samples, with 74 (40.2%) being ESBL producers. Among 47 patients with ESBL-PE who had medical records available, 38 (80.9%) had clinically significant UTIs. Most UTIs (63.2%) were community acquired and 34.2% were in patients with diabetes. Among 36 cultured ESBL-PE isolates, significant susceptibility (>80%) was only retained to amikacin and the carbapenems. The group 1 bla(CTX-M) gene was present in 90.0% of Escherichia coli isolates and all Klebsiella pneumoniae and Enterobacter cloacae isolates. The bla(SHV) and bla(TEM) genes were more common in K. pneumoniae (75% and 50%) and E. cloacae (50% and 50%) isolates than in E. coli (10% and 20%) isolates, respectively. CONCLUSION: The majority of UTIs caused by ESBL-PE were acquired in the community and due to organisms carrying the group 1 CTX-M ß-lactamase. Further epidemiologic studies of infections due to ESBL-PE are urgently needed to better prevent and treat these infections in South Asia.

Duke Scholars

Published In

Infect Chemother

DOI

ISSN

2093-2340

Publication Date

September 2016

Volume

48

Issue

3

Start / End Page

160 / 165

Location

Korea (South)
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Tillekeratne, L. G., Vidanagama, D., Tippalagama, R., Lewkebandara, R., Joyce, M., Nicholson, B. P., … Woods, C. W. (2016). Extended-spectrum ß-Lactamase-producing Enterobacteriaceae as a Common Cause of Urinary Tract Infections in Sri Lanka. Infect Chemother, 48(3), 160–165. https://doi.org/10.3947/ic.2016.48.3.160
Tillekeratne, L Gayani, Dhammika Vidanagama, Rashmi Tippalagama, Rashmi Lewkebandara, Maria Joyce, Bradly P. Nicholson, Ajith Nagahawatte, Champica K. Bodinayake, Aruna Dharshan De Silva, and Christopher W. Woods. “Extended-spectrum ß-Lactamase-producing Enterobacteriaceae as a Common Cause of Urinary Tract Infections in Sri Lanka.Infect Chemother 48, no. 3 (September 2016): 160–65. https://doi.org/10.3947/ic.2016.48.3.160.
Tillekeratne LG, Vidanagama D, Tippalagama R, Lewkebandara R, Joyce M, Nicholson BP, et al. Extended-spectrum ß-Lactamase-producing Enterobacteriaceae as a Common Cause of Urinary Tract Infections in Sri Lanka. Infect Chemother. 2016 Sep;48(3):160–5.
Tillekeratne, L. Gayani, et al. “Extended-spectrum ß-Lactamase-producing Enterobacteriaceae as a Common Cause of Urinary Tract Infections in Sri Lanka.Infect Chemother, vol. 48, no. 3, Sept. 2016, pp. 160–65. Pubmed, doi:10.3947/ic.2016.48.3.160.
Tillekeratne LG, Vidanagama D, Tippalagama R, Lewkebandara R, Joyce M, Nicholson BP, Nagahawatte A, Bodinayake CK, De Silva AD, Woods CW. Extended-spectrum ß-Lactamase-producing Enterobacteriaceae as a Common Cause of Urinary Tract Infections in Sri Lanka. Infect Chemother. 2016 Sep;48(3):160–165.

Published In

Infect Chemother

DOI

ISSN

2093-2340

Publication Date

September 2016

Volume

48

Issue

3

Start / End Page

160 / 165

Location

Korea (South)