First Report of Multidrug-Resistant ESBL-Producing Urinary Escherichia coli in Jordan

Aims: To detect ESBL-producing E. coli isolates and the genes underlying their resistance to β-lactams and sulfamethoxazole.
Place and Duration of Study: Department of Medical Laboratory Sciences, Jordan University of Science & Technology, Irbid 22110, Jordan, between January 2009 and December 2010.
Methodology: The blaCTX-M, blaTEM, blaSHV genes and sul genes were tested for in 165 urinary E. coli isolates by PCR assays. The association between the presence of gene and the antibiotic resistant was analyzed.
Results: Multidrug resistance was detected among the isolates. Eighty-three (50.3%) of the isolates were ESBL-producing, 67(80.7%) had either blaCTX-M or blaTEM, or both and none had blaSHV gene, sul2 (41.2%) was prevalent (21.8%) isolates had two sul genes, while (1.8%) isolates had three sul genes. A significant association (p ≤ 0.05) was found between blaCTX-M, or blaTEM and resistance to several antibiotics e.g., cefixime. Several (29.9%) of the ESBL-producing strains harbored multiple ESBL genes and had high resistance to various antibiotic classes.
Conclusion: The results revealed a high-level of sul2 and blaCTX-M positive ESBL isolates among other β-lactam resistant genes circulating in the community. These findings indicate that these patients are more likely to have ineffective initial empirical antimicrobial therapy.