The role of e.coli ESBL+ - Literature review Example

According to Farrell et al during the period 1999-2000 approximately 1291 bacterial isolates causing UTI were collected from different centres in UK and the most prevalent organism was E. coli which was found to be amoxicillin resistant. Other organisms isolated from UK during this period also included cefruoxime resistant Enterococcus faecalis, Klebsiella pneumoniae and Proteus mirabilis. In UK most of the E. coli causing community acquired and nosocomial infections are CTX-M producing and its control has been a challenge for the clinicians in the past and the years to come.

ESBLs may be of different types like TEM, CTX-M, OXA which includes many ESBLs differing in amino acid substitutions. Among the different β-lactams available, carbapenems were used against ESBL because they are relatively resistant to hydrolysis by most of the β lactamases. But, however with the advent of carbapenem resistant strains other alternatives like mecillinam and fosfomycin may be used to treat UTIs caused by ESBL producing E. coli with much success. One of the most common problems hovering human females is Urinary tract infection.

The annual incidence of UTIs in women is 12 % with the percentage rising to 18.6 % in the case of females aging between 20-25 years. Approximately 40 % to 50 % of women experience UTIs at least once in their lifetime and of these 25-33% experience a recurrence within 6-12 months. Normally, the urinary tract is sterile but bacterial infection may arise from the perianal region leading to UTI. Pathogens in the bladder may remain dormant or irritations and other symptoms like increased frequency of urination associated with pain and burning sensation, presence of blood and/ or pus in urine, nausea and vomiting, cramps or pain in the lower abdomen, fever and malaise in children, strong urine stench, pain during sexual intercourse and increased urgency of urination.

Asymptotic bacteriuria may be prevalent in 8% of the