Extended-spectrum β-lactamase variants in Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis from community- and hospital-acquired urinary tract infections

Extended-spectrum-β-lactamase (ESBL)-producing Enterobacterales, especially Escherichia coli, Klebsiella pneumoniae, and Proteus mirabilis, are highly prevalent in various parts of the world. However, the prevalence of ESBL variants in Enterobacterales from hospital-acquired (HA) and community-acquired (CA) urinary tract infections (UTI) had been infrequently reported in developing countries. This study analyzed the presence of ESBL-producing Enterobacterales, their resistance patterns, and ESBL variants. Of the 279 urine samples, 144 (51.6 %) were obtained from patients with CA-UTI and 135 (48.4 %) were obtained from patients with HA-UTI. From these samples, 145 and 135 Enterobacterales strains were isolated from the CA and HA-UTI groups, respectively. E. coli was the predominant (202/280; 72.2 %), followed by K. pneumoniae (53/280; 18.9 %) and P. mirabilis (25/280; 8.9 %). ESBL producers were higher (131/218; 60.09 %) in the HA-UTI isolates. Overall, blaSHV (48.2 %) was the predominant gene, followed by blaTEM (44 %), whereas blaCTX-M was rarely detected (7.79 %) in the CA and HA-UTI isolates. blaSHV-212, blaSHV-229, blaTEM-103, and blaTEM-104 were common among the isolates. The coexistence of blaTEM and blaSHV was also observed. This study highlights a different ESBL pattern among uropathogens that can aid in updating infectious disease control and antimicrobial stewardship guidelines. •E. coli is a predominant uropathogen in HA-, as well as, in CA-UTI.•Antibiotic resistance is high in HA-UTI compare to CA-UTI.•ESBL producers are prevalent in HA-UTI cases compared to CA-UTI cases.•blaSHV and blaTEM were predominantly found compared to blaCTX-M.