Editor response for version 3

Background: Extended-spectrum β-lactamase (ESBL) producing bacteria pose a global challenge because of resistance developing against a wide range of antimicrobial agents that complicate available treatment options. Thus, identifying the prevalent bacterial species producing ESBL enzymes and understanding how they are susceptible to antibiotics is necessary internationally to inform the effective treatment guidelines. Objective: To determine the prevalence and molecular characterization of ESBL bacteria causing Urinary Tract Infections (UTIs) in women who are pregnant at the Itojo Hospital, Ntungamo District. Methods: We conducted cross-sectional study where we collected and analyzed 340 urine samples. We did antimicrobial susceptibility testing using the Kirby Bauer disk diffusion method. Isolates were screened for ESBL production and confirmed using the combination disk test (CDT). Genotypic characterization was confirmed using multiplex PCR to detect blaTEM, blaCTX-M and blaSHV genes. Results: The prevalence of ESBL – producing bacteria was 29.7% (101/340). Escherichia coli (35.6%) and Klebsiella species (32.7%) were predominant ESBL producers. Genotypic analysis revealed blaTEM (49.5%) and blaCTX-M (30.7%) as the most prevalent genes, while blaSHV was less common (7.9%) Conclusion: The high prevalence of ESBL–producing bacteria and their resistance to commonly used antibiotics highlight the need for targeted antibiotic therapy, antimicrobial stewardship, and regular molecular surveillance.