Table 2.
Antimicrobial susceptibility pattern of the ESβL Enterobacteriaceae isolates
| Antibiotics | Total Enterobacteriaceae (n = 100), % | Escherichia coli (n = 66), % | Klebsiella spp. (n = 34), % | P- value | Hospital-acquired ESβL UTI (n = 48), % | Community- acquired ESβL UTI (n = 52), % | P-value | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| S | I + R | S | I + R | S | I + R | S | I + R | S | I + R | |||
| Imipenem | 100 | 0 | 100 | 0 | 100 | 0 | – | 100 | 0 | 100 | 0 | – |
| Meropenem | 100 | 0 | 100 | 0 | 100 | 0 | – | 100 | 0 | 100 | 0 | – |
| Ertapenem | 100 | 0 | 100 | 0 | 100 | 0 | – | 100 | 0 | 100 | 0 | – |
| Nitrofurantoin | 80 | 20 | 84.8 | 15.2 | 70.6 | 29.4 | 0.1 | 58.3 | 41.7 | 100 | 0 | < 0.001 |
| Cefoxitin | 76 | 24 | 69.7 | 30.3 | 88.2 | 11.8 | 0.1 | 72.9 | 27.1 | 78.8 | 21.2 | 0.5 |
| Piperacillin–tazobactam | 68 | 32 | 72.7 | 27.3 | 58.8 | 41.2 | 0.3 | 68.8 | 31.2 | 67.3 | 32.7 | 0.9 |
| Amikacin | 62 | 38 | 59.1 | 40.9 | 67.6 | 32.4 | 0.4 | 52.1 | 47.9 | 61.2 | 38.8 | 0.1 |
| Gentamicin | 50 | 50 | 50 | 50 | 50 | 50 | 0.9 | 45.8 | 54.2 | 53.8 | 46.2 | 0.1 |
| Cefoperazone–sulbactam | 45 | 55 | 37.9 | 62.1 | 58.8 | 41.2 | 0.1 | 50 | 50 | 40.4 | 59.6 | 0.5 |
| Levofloxacin | 39 | 61 | 27.3 | 72.7 | 61.8 | 38.2 | 0.001 | 39.6 | 60.4 | 38.5 | 61.5 | 1 |
| Ofloxacin | 37 | 63 | 25.8 | 74.2 | 58.8 | 41.2 | 0.001 | 35.4 | 64.6 | 38.5 | 61.5 | 0.6 |
| Ciprofloxacin | 32 | 68 | 25.8 | 74.2 | 44.1 | 55.9 | < 0.001 | 33.3 | 66.7 | 30.8 | 69.2 | 0.9 |
| Doxycycline | 31 | 69 | 33.3 | 66.7 | 26.5 | 73.5 | 0.4 | 33.3 | 66.7 | 28.8 | 71.2 | 0.7 |
| Trimethoprim– sulfamethoxazole | 26 | 74 | 24.2 | 75.8 | 29.4 | 70.6 | 0.7 | 31.2 | 68.8 | 21.2 | 78.8 | 0.3 |
| Amoxicillin–clavulanate | 7 | 93 | 9.1 | 91.9 | 2.9 | 97.1 | 0.5 | 8.3 | 91.7 | 5.8 | 94.2 | 0.5 |
| Cefepime | 3 | 97 | 4.5 | 95.5 | 0 | 100 | 0.7 | 0.5 | 99.5 | 3.8 | 96.2 | 0.5 |
| Cefotaxime | 0 | 100 | 0 | 100 | 0 | 100 | – | 0 | 100 | 0 | 100 | – |
| Ceftazidime | 0 | 100 | 0 | 100 | 0 | 100 | – | 0 | 100 | 0 | 100 | – |
| Ceftriaxone | 0 | 100 | 0 | 100 | 0 | 100 | – | 0 | 100 | 0 | 100 | – |
| Aztreonam | 0 | 100 | 0 | 100 | 0 | 100 | – | 0 | 100 | 0 | 100 | – |
| Fosfomycin | – | – | 100 | 0 | – | – | – | – | – | – | – | – |
ESβL = extended-spectrum β-lactamase; I = intermediate; R = resistant; S = susceptible; UTI = urinary tract infection. Extended-spectrum β-lactamase isolates were extremely resistant to cefepime and amoxicillin–clavulanic acid, and susceptible to carbapenems. All ESβL E. coli isolates19 were sensitive to fosfomycin. The resistance rate of E. coli isolates to fluoroquinolones (levofloxacin, ofloxacin, and ciprofloxacin) was significantly higher than that of Klebsiella (P-value = 0.001, 0.001, and < 0.001, respectively). Extended-spectrum β-lactamase isolates from community-acquired UTIs were significantly more susceptible to nitrofurantoin than the ESβL isolates from hospital-acquired UTIs (P-value < 0.001).