Journal of Pure and Applied MicrobiologyVol. 9 No. 3

Prevalence of Extended-Spectrum Beta-Lactamase Producing Enterobacteriaece from various Clinical Isolates in Al-ansar Hospital, Medina, Saudi Arabia

Ziab Zakey Al-ahmadey

Al-Ansar Hospital, Ministry of Health, Al-Madinah, Saudi Arabia.

Received on 06 April 2015 and accepted on 19 June 2015

 

ABSTRACT

Extended spectrum beta-lactamases (ESBLs) producing Enterobacteriaceae. The enzyme is an increasing problem in hospitals worldwide. Therefore, it is imperative to quantify the problem, and reinforce guidelines promoting appropriate antibiotic use. The purpose of this study was to evaluate the incidence of ESBL and to analyze their antibiotic susceptibility in Enterobacteriaceae isolate from different sources Al-ansar hospital, in Medina, Saudi Arabia. A total of 283 were examined by direct microscopy (Gram stain and methylene blue) and parallel cultured in selective and non-selective media, therefore obtained between January and June 2014. All isolates were identified and tested for susceptibility by the VITEK II system (bioMérieux, Marcy l’Etoile, France) using the card for Gram-negative strains (GN cards) and AST-N291. Antibiotic susceptibility testing to beta-lactam/bate-lactamase inhibitor, cephalosporins, aminoglycosides, and carbapenems were performed by disk diffusion method. As for the identity of recovered 101 Enterobacteriaceae ESBL produce isolates, including Escherichia coli (57%), Klebsiella pneumoniae (40%), andProteus mirabilis (3%). ESBL phenotype was seen in 14 (40%) of tracheal secretion isolates, 43(39%) from urine, 3(37%) from pus, and 13(36%) from sputum. wound and blood specimens were also encountered at a frequency of 31% and 29%, respectively. E.coli was most resistance to cotrimaxazole (68%), nitrofurantoin (50%), amoxicillin/clavulanate (51%), piperacillin/tazobactam and ciprofloxacin (40% and 33%, respectively). K. pneumoniae was sensitive to imipenum (97%), meropenem (97%), amikacin (93%), and gentamicin (70%). P.mirabilis, E. cloacae, P. stuartii, and S. marcescens, strains were sensitive to amikacin, impenem, and meropenem antibiotics. Three isolates had reduced susceptibility to carbapenems. This study showed the existence of important ESBLs among the Enterobacteriaceae isolated from inpatients and outpatient. Continuous surveillance of ESBLs, in bacteria isolated from these patients have an important clinical impact, since, it can often provide valuable information for effective infection control measures and for the choice of appropriate antimicrobial therapy. The empiric use of third and fourth generation cephalosporins should be curtailed, as cephalosporin use was associated with an increased risk of ESBL production.

Keywords : Extended spectrum beta-lactamases (ESBLs), Enterobacteriaceae, Escherichia coli, Klebsiella pneumonia, antibiotic.