scholarly journals Antibiotic Consumption and Resistance Pattern of 3 Coagulase-Negative Staphylococci Species: An Ecological Study

2021 ◽  
pp. 251-257
Author(s):  
Herleeyana Meriyani ◽  
Dwi Arymbhi Sanjaya ◽  
Ketut Agus Adrianta
Keyword(s):  
Antibiotic Resistance ◽  
Ecological Study ◽  
Secondary Data ◽  
Antibiotic Consumption ◽  
Diffusion Method ◽  
Resistance Pattern ◽  
Coagulase Negative Staphylococci ◽  
Disk Diffusion Method ◽  
Factors Affecting ◽  
Bed Days

A group of coagulase-negative staphylococci (CoNS) was historically classified as a nonpathogenic bacteria. Over the last few decades, nosocomial infections caused by CoNS as opportunistic pathogens have increased and become one of the major nosocomial pathogens. The aim of this study was to identify the relationship between the use of an antibiotic agent for CoNS in Bali’s regional public hospital and the development of antibiotic resistance during 3 years period. This study was a retrospective ecological study of antibiotic resistance and antibiotic consumption secondary data collected prospectively. It was conducted over a three years period of inpatient data. Susceptibility of CoNS to antibiotics was obtained from the hospital antibiogram of all isolates from 2017 to 2019. Sensitivity results in antibiogram were based on the standards provided by the Clinical and Laboratory Standards Institute (CLSI) with the disk diffusion method. Antibiotic consumption in DDDs/100 bed-days. The relationships between DDDs/100 bed-days of each antibiotic and rates of antibiotic resistance of each resistant strain of CoNS were tested using Spearman correlation and logistic regression. There was no significant correlation between antibiotic consumption (DDD) and the percentage of antibiotic resistance among the three CoNS species (p>0.05). However, this study found there was an inverse relationship between DDD and antibiotic resistance in Staphylococcus hominis species (OR = 0.063; CI [0.004-0.915]; p=0.043). We conclude that no significant correlation between antibiotic consumption and antibiotic resistance of the 3 CoNS species. There needs to be further research to identify antibiotic consumption, antibiotic resistance and other factors affecting antibiotic resistance.

scholarly journals Antibiotic Resistance ofSalmonellaspp. Isolated from Shrimp Farming Freshwater Environment in Northeast Region of Brazil

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Fátima C. T. Carvalho ◽  
Oscarina V. Sousa ◽  
Edirsana M. R. Carvalho ◽  
Ernesto Hofer ◽  
Regine H. S. F. Vieira
Keyword(s):  
Drug Resistance ◽  
Antibiotic Resistance ◽  
Shrimp Farming ◽  
Diffusion Method ◽  
Resistance Pattern ◽  
Plasmid Curing ◽  
Freshwater Environment ◽  
Disk Diffusion Method ◽  
Northeast Region ◽  
Drug Resistance Pattern

This study investigated the presence and antibiotic resistance ofSalmonellaspp. in a shrimp farming environment in Northeast Region of Brazil. Samples of water and sediments from two farms rearing freshwater-acclimatedLitopenaeus vannameiwere examined for the presence ofSalmonella. Afterwards,Salmonellaisolates were serotyped, the antimicrobial resistance was determined by a disk diffusion method, and the plasmid curing was performed for resistant isolates. A total of 30 (16.12%) of the 186 isolates were confirmed to beSalmonellaspp., belonging to five serovars:S. serovar Saintpaul,S. serovar Infantis,S. serovar Panama,S. serovar Madelia, andS. serovar Braenderup, along with 2 subspecies:S. entericaserovar houtenae andS. entericaserovar enterica. About twenty-three percent of the isolates were resistant to at least one antibiotic, and twenty percent were resistant to at least two antibiotics. Three strains isolated from water samples (pond and inlet canal) exhibited multiresistance to ampicillin, tetracycline, oxytetracycline, and nitrofurantoin. One of them had a plasmid with genes conferring resistance to nitrofurantoin and ampicillin. The incidence of bacteria pathogenic to humans in a shrimp farming environment, as well as their drug-resistance pattern revealed in this study, emphasizes the need for a more rigorous attention to this area.

scholarly journals Investigation of Antibiotic Resistance and Biofilm Formation in Clinical Isolates of Klebsiella pneumoniae

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Kiana Karimi ◽  
Omid Zarei ◽  
Parinaz Sedighi ◽  
Mohammad Taheri ◽  
Amin Doosti-Irani ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Klebsiella Pneumoniae ◽  
Biofilm Formation ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Resistance Pattern ◽  
Chi Square ◽  
Disk Diffusion Method ◽  
High Level ◽  
Tract Infections

Aim. Klebsiella pneumoniae (K. pneumoniae) is an encapsulated Gram-negative bacterium that can lead to 14–20% of nosocomial infections. The ability of biofilm formation in this bacterium decreases the host immune response and antibiotic efficacy. This may impose a huge impact on patients and healthcare settings. This study aimed to evaluate the antibiotic resistance pattern and biofilm formation in K. pneumoniae strains isolated from two major Hamadan hospitals, west of Iran. Methods. A total of 83 K. pneumoniae strains were isolated from clinical samples of patients in different wards of Hamadan hospitals from September 2018 to March 2019. Determination of antimicrobial susceptibility was performed using the disk diffusion method. Biofilm formation was evaluated by the crystal violet method. Data were analyzed by the SPSS software and chi-square test. Results. The results showed that clinical samples included 18 urinary tract samples (22%), 6 wound samples (7%), 6 blood samples (7%), 17 tracheal tube aspiration samples (20%), 32 throat cultures (38%), 2 sputum samples (2.5%), and 2 abscess drain cultures (2.5%). High-level resistance to cefotaxime was detected in 92%, and all of isolates were susceptible to colistin. Biofilm formation was seen in 62 (75%) isolates. Strong biofilm formation was observed in 17 (20%) strains. A significant correlation was seen between biofilm formation and antibiotic resistance ( P value <0.05). Conclusion. Our findings emphasize the need for proper diagnosis, control, and treatment of infections caused by K. pneumoniae especially in respiratory tract infections due to the strong biofilm formation and high antibiotic resistance in these strains.

Detection of Virulence Factors and Antibiotic Resistance Pattern of Clinical and Intensive Care Unit Environmental Isolates of Pseudomonas aeruginosa

2020 ◽  
Vol 20 (5) ◽  
pp. 758-762
Author(s):  
Omid Zarei ◽  
Hassan Mahmoudi ◽  
Ali Mohammadi Bardbari ◽  
Pezhman Karami ◽  
Mohammad Yousef Alikhani
Keyword(s):  
Intensive Care Unit ◽  
Pseudomonas Aeruginosa ◽  
Antibiotic Resistance ◽  
Intensive Care ◽  
Virulence Factors ◽  
Opportunistic Pathogen ◽  
Diffusion Method ◽  
Resistance Pattern ◽  
Disk Diffusion Method ◽  
Human Infections

Background: Pseudomonas aeruginosa is a gram-negative non-glucose fermenting aerobic bacteria and an opportunistic pathogen in humans and animals. The present study was carried out to investigate the distribution of virulence factors and antibiotic resistance properties of P. aeruginosa isolated from patients and intensive care unit (ICU) environment. Material and Methods: A total of 116 P. aeruginosa isolated from patients and ICU environment were collected from Besat hospital in Hamadan, the West of Iran. P. aeruginosa isolates were analyzed based on the presence of the virulence factors encoding genes included exoA, exoS, exoU, and algD using polymerase chain reaction (PCR). Antimicrobial susceptibility test was performed using a disk diffusion method. Results: The results showed the prevalence of exoA 33 (56.9%), exoS 21 (36.20%), exoU 37 (63.8%), and algD 35 (60.34%) genes in ICU environment P. aeruginosa strains and exo A 23 (39.25%), exoS 25 (43.1%), exoU 40(68.98%), and algD 25 (43.1%) genes in clinical isolates of P. aeruginosa. High resistance levels of the clinical and ICU environment isolate to ampicillinsulbactam (100%), were also observed. Conclusions: Our findings should raise awareness about antibiotic resistance in hospitalized patients in Iran. Clinicians should exercise caution in prescribing antibiotics, especially in cases of human infections.

scholarly journals Phylogenetic Groups ofEscherichia coliStrains from Patients with Urinary Tract Infection in Iran Based on the New Clermont Phylotyping Method

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Darioush Iranpour ◽  
Mojtaba Hassanpour ◽  
Hossein Ansari ◽  
Saeed Tajbakhsh ◽  
Gholamreza Khamisipour ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Cross Sectional Study ◽  
Diffusion Method ◽  
Resistance Pattern ◽  
Multiple Drug ◽  
Phylogenetic Groups ◽  
Disk Diffusion Method ◽  
Cross Sectional ◽  
E Coli ◽  
Pcr Method

Objectives.In 2013, Clermont classifiedE. colistrains into eight phylogenetic groups using a new quadruplex PCR method. The aims of this study were to identify the phylogenetic groups ofE. colibased on this method and to assess their antibiotic resistance patterns in Bushehr, Iran.Methods. In this cross-sectional study, 140E. coliisolates were subjected to phylogenetic typing by a quadruplex PCR method. Antimicrobial susceptibility testing was performed by disk diffusion method.Results. Phylogenetic group B2 was most predominant (39.3%), followed by unknown (27.1%), E (9.3%), C and clade I (each 6.4%), B1 (5%), F and D (each 2.9%), and A (0.7%). The most common antibiotic resistance was related to amoxicillin (82.1%) and the least to meropenem (0.7%). 82.14% of isolates were multiple drug resistant (MDR). Antibiotic resistance was mainly detected in group B2 (50%).Conclusions.Our findings showed the high prevalence of MDRE. coliisolates with dominance of group B2. About 25% ofE. coliisolates belong to the newly described phylogroups C, E, F, and clade I. Such studies need to be done also in other regions to provide greater understanding of the antibiotic resistance pattern and the prevalences of different phylogenetic groups.

scholarly journals Antibiotic resistance in Pakistan: a systematic review of past decade

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hazrat Bilal ◽  
Muhammad Nadeem Khan ◽  
Tayyab Rehman ◽  
Muhammad Fazal Hameed ◽  
Xingyuan Yang
Keyword(s):  
Antibiotic Resistance ◽  
High Resistance ◽  
Clinical Laboratory ◽  
World Health ◽  
Diffusion Method ◽  
Resistance Pattern ◽  
Original Research ◽  
Disk Diffusion Method ◽  
Phenotypic Resistance ◽  
E Coli

Abstract Background During the last six decades, extensive use of antibiotics has selected resistant strains, increasing the rate of fatal infectious diseases, and exerting an economic burden on society. This situation is widely accepted as a global problem, yet its degree is not well elucidated in many regions of the world. Up till now, no systemic analysis of Antimicrobial resistance (AMR) in Pakistan has been published. The current study aims to describe the antibiotic-resistance scenario of Pakistan from human samples of the last 10 y, to find the gaps in surveillances and methodology and recommendations for researchers and prescribers founded on these outcomes. Methods Original research articles analyzed the pattern of Antibiotic resistance of any World Health Organization (WHO) enlisted priority pathogens in Pakistan (published onward 2009 till March 2020), were collected from PubMed, Google scholar, and PakMedi Net search engines. These articles were selected based on predefined inclusion and exclusion criteria. Data about the study characteristics and antibiotic-resistance for a given bacterium were excluded from literature. Antibiotic resistance to a particular bacterium was calculated as a median resistance with 95% Confidence Interval (CI). Results Studies published in the last 10 y showed that Urinary Tract Infection (UTI) is the most reported clinical diagnosis (16.1%) in Pakistan. E. coli were reported in 28 (30.11%) studies showing high resistance to antibiotics’ first line. Methicillin-resistant Staphylococcus aureus (MRSA) was found in 49% of S. aureus’ total reported cases. Phenotypic resistance pattern has mostly been evaluated by Disk Diffusion Method (DDM) (82.8%), taken Clinical Laboratory Standards Institute (CLSI) as a breakpoint reference guideline (in 79.6% studies). Only 28 (30.11%) studies have made molecular identification of the resistance gene. blaTEM (78.94% in Shigella spp) and blaNDM-1 (32.75% in Klebsiella spp) are the prominent reported resistant genes followed by VanA (45.53% in Enterococcus spp), mcr-1 (1.61% in Acinetobacter spp), and blaKPC-2 (31.67% in E. coli). Most of the studies were from Sindh (40.86%), followed by Punjab (35.48%), while Baluchistan’s AMR data was not available. Conclusion Outcomes of our study emphasize that most of the pathogens show high resistance to commonly used antibiotics; also, we find gaps in surveillances and breaches in methodological data. Based on these findings, we recommend the regularization of surveillance practice and precise actions to combat the region’s AMR.

scholarly journals Antibiotics Resistance Pattern of Staphylococcus aureus Isolated From In-patients of an Orthopaedic Hospital in North-Western Nigeria

2021 ◽  
Vol 8 (4) ◽  
pp. 160-166
Author(s):  
Dominic Agbo Oche ◽  
Paul Ifeleke Oyegoke ◽  
Maryloveth Oluchukwu Akpudo ◽  
Busayo Olalekan Olayinka
Keyword(s):  
Staphylococcus Aureus ◽  
Antibiotic Resistance ◽  
Bone Diseases ◽  
Diffusion Method ◽  
Resistance Pattern ◽  
Antibiotics Resistance ◽  
Drug Resistant ◽  
Disk Diffusion Method ◽  
Cross Sectional ◽  
Orthopaedic Hospital

Background and aims: Staphylococcus aureus, an important pathogen in bone diseases, is a highly multi-drug resistant (MDR) bacterium. This study aimed to investigate the antibiotic resistance among S. aureus isolated from patients on admission in an orthopaedic hospital. Methods: In this cross-sectional research, 140 samples comprising urine samples, wound swabs, and nasal swabs were collected from 49 patients on admission. Samples were cultured and screened for S. aureus following standard procedures. Using the agar-disk diffusion method, the isolates were subjected to antibiotics susceptibility tests. Results: S. aureus were isolated from 26 (18.6%) samples, and wound swabs were found to have the highest number of the S. aureus isolates with 12 (46.2%). Among the 26 S. aureus isolated, 25 (96.2%) isolates were resistant to at least four or more of the tested antibiotics. There were 23 (88.5%) MDR isolates, while there were only 2 (7.6%) extensively drug resistant ones. The number of methicillin-resistant S. aureus were 17 (65.4% of the isolates), while the number of methicillin-susceptible S. aureus were 9 (34.6% of the isolates). A total of 22 (84.6%) isolates had multi-antibiotic resistance (MAR) index greater than 0.2. Inducible clindamycin resistance of 2 (7.6%) was observed. Conclusion: This study showed that the S. aureus isolated from the patients were resistant to multiple antibiotics. Regular surveillance of antibiotic resistance is of utmost importance, since it facilitates the design or development of the treatment regimens that could check the spread of antimicrobial resistance.

scholarly journals Exploring Antibiotic Resistance Pattern of Escherichia coli, Salmonella spp., and Staphylococcus spp. Isolated from Eggs in Rajshahi

2021 ◽  
Vol 3 (4) ◽  
pp. 25-30
Author(s):  
Md Hakimul Haque ◽  
Md. Mizanur Rahman ◽  
Md. Lovelu Miah ◽  
Soshe Ahmed ◽  
Md. Rabiul Islam Sazib ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Bacterial Pathogen ◽  
Diffusion Method ◽  
Resistance Pattern ◽  
Salmonella Spp ◽  
Isolation And Identification ◽  
Disk Diffusion Method ◽  
E Coli ◽  
Antibiotic Resistance Pattern ◽  
Staphylococcus Spp

Chicken eggs are a major component of people’s diets, with an average yearly consumption of approximately 103 eggs per person in Bangladesh. Eggs act as an important carrier of food-borne pathogen worldwide. The study was conducted to identify the prevalence and antibiotic resistance pattern of E. coli, Salmonella spp., and Staphylococcus spp., in eggs isolated from farms and different markets of Rajshahi, Bangladesh. A total of 60 eggs were collected randomly between April to December 2019. The isolation and identification of bacterial pathogen was done in accordance with standard procedures. The bacterial isolates were subjected to antibiotic susceptibility testing against seven commonly used antibiotics using Kirby-Bauer disk diffusion method. An overall prevalence of E. coli, Salmonella spp., and Staphylococcus spp. were found to be 35.0%, 28.33%, and 23.33%, respectively. E. coli were found highly resistant to penicillin (100%), tetracycline (80.95%), ampicillin (100%), and erythromycin (85.71%) and were sensitive to amoxicillin (71.42%), ciprofloxacin (85.71%), and gentamicin (95.23%). Salmonella spp. was highly resistant to penicillin (100%), erythromycin (82.35%) and tetracycline (82.35%), and was sensitive to gentamicin (94.11%), amoxicillin (76.47%) and ciprofloxacin (70.58%). Staphylococcus spp. was resistant to penicillin (100%), erythromycin (78.57%), tetracycline (85.71%), amoxicillin (100%), and ampicillin (100%) but sensitive to ciprofloxacin (85.71%), and gentamicin (92.85%). The higher prevalence of multidrug-resistant (MDR) bacteria can easily enter the food chain, which poses a public health threat.

scholarly journals Bacterial Contamination of Iranian Paper Currency and Their Antibiotic Resistance Patterns

2017 ◽  
Vol 5 (4) ◽  
pp. 106-110 ◽  
Author(s):  
Farzaneh Firoozeh ◽  
Ehsan Dadgostar ◽  
Hussein Akbari ◽  
Mohammad Zibaei ◽  
Seyed Mohammad Sadjjad Sadjjadian ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Bacterial Contamination ◽  
Diffusion Method ◽  
Coagulase Negative Staphylococci ◽  
Disk Diffusion Method ◽  
Paper Currency ◽  
Microbiological Methods ◽  
Resistance Patterns ◽  
Resistance Rates ◽  
Antibiotic Resistance Patterns

Background: Paper banknotes would be a vector for transmission of pathogenic microorganisms through handling. Objective: This study aimed to determine bacterial contamination of Iranian paper currencies in circulation and their antibiotic resistance patterns. Materials and Methods: In this study, 337 currency notes of different value were collected from markets, shops, restaurants, bus stations and banks in Kashan, Iran during April 2015 to March 2016. The currency notes transferred to microbiology laboratory and were tested for bacterial contamination using standard microbiological methods. Antibiotic resistance patterns of isolated bacteria were determined by disk diffusion method according to the Clinical and Laboratory Standards Institute (CLSI) standards. The results and data were analyzed using descriptive statistics. Results: Of 337 currency notes, 262 (77.7%) were identified with bacterial contamination. Bacteria isolated from currency notes were as follows: Bacillus spp 113 (43.1%), coagulase-negative staphylococci 99 (37.7%), Escherichia coli 20 (7.6%), Enterococci species 14 (5.3%), Staphylococcus aureus 8 (3.1%), Klebsiella spp 4 (1.5%), Shigella species 2 (0.8%), and Pseudomonas species 2 (0.8%). The most and least contaminated currency notes were 50000 and 500 Rials, respectively. The highest resistance rates in gram-negative rods were against nalidixic acid, and ampicillin. However, the highest resistance rates in S. aureus, coagulase-negative staphylococci and Enterococci species were against ampicillin, erythromycin and tetracycline. Conclusion: Our study revealed that the bacterial contamination among Iranian paper currency in circulation especially those obtained from certain sources including shops and bus stations is high and in most cases these bacterial isolates are antibiotic-resistant strains.

Antibiotic Resistance Patterns and Molecular Typing of Acinetobacter Baumannii Strains Isolated from Burn Patients in Iran

2018 ◽  
Author(s):  
Fahimeh Nourbakhsh ◽  
Elaheh Tajbakhsh ◽  
Dana Daneshmand ◽  
Samaneh Borooni ◽  
Vajiheh Nourbakhsh
Keyword(s):  
Antibiotic Resistance ◽  
Acinetobacter Baumannii ◽  
Molecular Typing ◽  
Multidrug Resistant ◽  
Diffusion Method ◽  
Resistance Pattern ◽  
Burn Patients ◽  
Disk Diffusion Method ◽  
Burn Center ◽  
Antibiotic Resistance Pattern

Background and Aims: Acinetobacter baumannii is an important multidrug-resistant opportunistic pathogen frequently causing various nosocomial infections and is a serious threat to burn patients. These infections are usually caused by the outbreak strains. The aim of this study was to show antibiotic resistance pattern and molecular typing of A.baumannii genes isolates collected from burn patients and also distribution of different types of burn patients. Materials and Methods: In this study, 307 different strains were detected. Totally 100 A.baumannii strain was selected in burn center of Isfahan hospital. Antibiotic resistance pattern was determined by disk diffusion method (Kirby Bauer). The presence of genes coding in antibiotic resistance were analyzed by using M-PCR method. The standard strains of Escherichia coli ATCC 25922 and A. baumannii ATCC 19606 were used as negative and positive controls. Results: The antibiotic resistance pattern for A.baumannii showed high resistance for ciprofloxacin, ceftazidime, and tetracycline with frequency of 82.5%, 75.3%, 72%, respectively. Moreover, the most sensitive antibiotics were chloramphenicol, and nitrofurantoin with the resistance frequency of 3.9% and 2.8%. CITM (91.1%) was the highest detected gene. Conclusions: High prevalence of antibiotic resistance pattern among A.baumannii isolated from burn center hospitals indicates the important role of multidrug resistant isolates.

Isolation frequency of uropathogenic strains and search for ESBL producing Enterobacteriaceae isolated from patients with UTI in Bechar (Algeria)

2020 ◽  
Vol 18 ◽  
Author(s):  
Elhassan Benyagoub ◽  
Miaad K. Alkhudhairy ◽  
S. Mohamed Benchaib ◽  
Abdelmadjid Zaalan ◽  
Youcef Mekhfi ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Multidrug Resistance ◽  
Health Sector ◽  
Multidrug Resistant ◽  
Health Concern ◽  
Diffusion Method ◽  
Resistance Pattern ◽  
Disk Diffusion Method ◽  
E Coli ◽  
Klebsiella Spp

Background: Emergence of multidrug-resistant uropathogenic strains mainly the global spread of extended-spectrum betalactamase (ESBL) genes accompanied both by uncontrolled use of antibacterial agents and a considerable decrease in their activities makes the monitoring of the resistance pattern one of necessary means that could help the medical practitioners to choose the best treatment. For this purpose and during four months from March 1 to June 30 (2019), an experimental study has been carried out on urine specimens of 123 inpatients (IP) and outpatients (OP) at infectious disease service Boudjemaa TOURABI Public Hospital of Bechar (Algeria), aiming the detection of ESBL-producing Enterobacteriaceae uropathogenic strains. Methods: Firstly, the antibiotic susceptibility testing has been carried out by using the disk diffusion method to determine not only the multidrug resistance patterns, but also the multiple antibiotic resistance indexes of uropathogenic strains isolated from clinical IP and OP samples. Secondly, the ESBL detection was done by using the following methods: synergy tests based on the synergy between a thirdgeneration cephalosporin and clavulanate, double-disc synergy test (DDST) and phenotypic tests on a cloxacillin-containing agar. Results: As a result, 56 patients had a urinary tract infection (UTI) in overall 123 patients; a frequency of 45,52%. Through a UTI’s frequency of 64,7%, the female gender was the most affected. All age groups were affected by UTI, with a mean age of 38,47±19,97 years old. Knowing that UTIs’ patients having ages ranged from 16 to 49 years old were most affected compared to other ages’ groups, with a frequency of 66,6 and 50% for female and male gender, respectively. The microbial strains represented by the bacteria group were predominant, ie (98,22%) followed by yeasts (1,78%), where Gram-negative bacilli showed (96,36%) of the uropathogenic agents, so (3,64%) were Gram-positive bacteria. The antibiotic resistance profile of isolated Enterobacteriaceae showed very high resistance rates for the species of Escherichia coli, Klebsiella spp, and Proteus spp to aminopenicillins, cephalosporins, and less against carbapenems and other drug groups. E. coli had presented the highest multidrug resistance followed by Klebsiella spp with a MAR index ranged from 0,53 to 0,82. Within this range, a total of 28 isolate (25 E. coli, 2 Klebsiella spp, and 1 Proteus mirabilis) had shown resistance against 9 to 14 out of the 17 tested antibiotics. The rate of ESBL-producing Enterobacteriaceae strains was 23,07 and 55,26% for inpatients and outpatients respectively, where E.coli was the most important ESBL producers out of all isolated strains. Conclusion: An alarming ESBLs rate for outpatients which is usually higher among inpatients with UTI, who receive several classes of antibiotics. Such condition should be considered as a major public health concern, and measures must be taken to establish the sources and drivers of this issue. Thus, the findings of this research pushes health sector stakeholders as well as scientific communities to act on reducing the transmission of the multidrug-resistant strains that threatens several classes of life-saving antibiotics.

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