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Background  Emergence of antibacterial resistance and production of Extended spectrum β-lactamases (ESBLs) are responsible for the frequently observed empirical therapy failures. Most countries have experienced rapid dissemination of ESBLs producing Enterobacteriaceae isolates, particularly  E. coli  and  Klebsiella pneumoniae . ESBLs are clinically significant and when detected, indicate the need for the use of appropriate antibacterial agents. But antibacterial choice is often complicated by multi-resistance.    Methods  This study was carried from June to November 2014 to study the multidrug resistant (MDR) Enterobacteriaceae and ESBL producing  E. coli  among urine isolates in hospital setting. Isolates from urine samples were primarily screened for possible ESBL production followed by phenotypic confirmation. Antibiotic susceptibility testing (AST) was done by Kirby Bauer disk diffusion method following Clinical and Laboratory Standard Institute (CLSI) guidelines.    Results  Out of 450 urine samples processed, 141 significant growths were obtained including 95 Enterobacteriaceae isolates with 67  E. coli . Among Enterobacteriaceae, 92 (96.84 %) were recorded as MDR and 18 (26.87 %)  E. coli  were confirmed as ESBLs producers.    Conclusions  Using the phenotypic confirmatory test forwarded by the CLSI, relatively significant  E. coli  isolates tested were ESBL producers. Also high numbers of MDR organisms were isolated among Enterobacteriaceae. Isolates showed significant resistance to the commonly prescribed drugs. These findings suggest for further study in this field including the consequences of colonization with MDR and ESBL-producing bacteria both in the community and in the hospital setting.

antimicrobial resistance and infection control

Multidrug resistant Enterobacteriaceae and extended spectrum β-lactamase producing Escherichia coli: a cross-sectional study in National Kidney Center, Nepal