Phenotypic Detection of Extended-Spectrum β-Lactamase and Antimicrobial Resistance Patterns in Multidrug-Resistant Uropathogenic Enterobacterales at a Tertiary-Care Hospital in Bangladesh
Abstract
Background: Urinary tract infections (UTIs) are common bacterial infections worldwide, and increasing multidrug resistance (MDR) and extended-spectrum β-lactamase (ESBL) production among uropathogenic Enterobacterales have increasingly limited empirical and targeted treatment options, particularly in low- and middle-income countries.
Methods: This laboratory-based cross-sectional study was conducted at Bangladesh Medical University, Dhaka, Bangladesh. Eligible MDR uropathogenic Enterobacterales isolates from routine diagnostic urine specimens were collected and tested after Institutional Review Board approval on 13 July 2025. Urine specimens were obtained as part of standard hospital diagnostic procedures from patients with suspected UTI. A total of 122 MDR isolates were included. Bacterial identification was performed using conventional biochemical methods. Antimicrobial susceptibility testing was performed by Kirby-Bauer disk diffusion following CLSI 2024 guidelines, and phenotypic ESBL production was detected by the double-disc synergy test. MDR classification was based on the complete routine antimicrobial susceptibility testing record, including amikacin and gentamicin. Descriptive statistics and exact binomial 95% confidence intervals (CIs) were calculated.
Results: Among these 122 MDR isolates, Escherichia coli was predominant (81/122, 66.4%), followed by Klebsiella spp. (38/122, 31.1%) and Proteus spp. (3/122, 2.5%). Resistance was highest to nalidixic acid (122/122,…
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Evidence Hub reads this as a cross-sectional. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause.
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