ESBL-producing Escherichia coli and Klebsiella pneumoniae at a tertiary care hospital in Saudi Arabia

Abstract

Introduction: The increasing frequency and antibiotic resistance among extended-spectrum β-lactamases (ESBLs)-producing bacteria are posing a serious threat. This study sought to investigate the frequency and antibiotic susceptibility of ESBL-producing E. coli and K. pneumoniae at a tertiary care hospital. Methodology: Data were collected from samples sent to the microbiology laboratory between 2006 and 2010 at King Khalid University Hospital, Riyadh. ESBLs were confirmed using Etest strips of cefotaxime/cefotaxime + clavulanic acid, ceftazidime/ceftazidime + clavulanic acid, and cefepime/cefepime + clavulanate. Results: Out of 17,105 samples, 1,076 (6.3%) ESBL-producing isolates of E. coli (808) and K. pneumoniae (268) were confirmed. Among these, 680 (63.2%) isolates were found in urine samples, followed by 287 (26.7%) in superficial swabs, deep wounds swabs, tissues and sterile body fluids, 71 (6.6%) in respiratory, and 38 (3.5%) in blood samples. The overall frequency rates of ESBL E. coli and K. pneumoniae were 6.6% and 5.5%, respectively. The frequency of ESBL-producing E. coli and K. pneumoniae increased significantly during the study period. E. coli resistance against cotrimoxazole was 71.1%, followed by ciprofloxacin (68.2%) and gentamicin (47%). Similarly, 62.7% of K. pneumoniae isolates were resistant to gentamicin, 59.5% to cotrimoxazole, and 49.8% to ciprofloxacin. There was no statistically significant change in antimicrobial resistance over the study period. Conclusions: Although the frequency rates of ESBL-producing E. coli and K. pneumoniae increased, no change in the anti-microbial susceptibility was observed over the study period.

ESBL Production Among E. coli and Klebsiella spp. Causing Urinary Tract Infection: A Hospital Based Study

“…In this study, E. coli were highly resistant to amoxicillin 269 (73.7%) and least resistant to imipenem 7 (1.9%). This is similar to reports of different studies [21, 23, 24, 29-31, 33, 35-41]. Likewise, most Klebsiella spp.…”

“…were highly resistant to amoxicillin 18 (90%) and least resistant to gentamycin 0 (0%) and imipenem 0 (0%). Similar result was shown in different studies [29, 33, 35, 36, 38, 41, 42]. Imipenem was the most effective drug, however, it should not be administered as empirical drug unless infection is life threatening, as carbapenems are considered the drug of last resort.…”

Increasing Incidence of Extended-Spectrum β-Lactamase-ProducingEscherichia coliin Community Hospitals throughout the Southeastern United States

“…Including data from our prior analysis, 11 our data demonstrate that the epidemiology of ESBL-KP remained largely unchanged from 2005 to 2014. Although the rate of ESBL-KP infections has increased in some geographic locations, 16,17 other investigators have also described a trend of stable ESBL-KP infections and rising ESBL-EC infections similar to our findings in this study. 8,18 …”

Extended-Spectrum beta (β)-Lactamases and Antibiogram in Enterobacteriaceae from Clinical and Drinking Water Sources from Bahir Dar City, Ethiopia

“…Similarly, studies stated that ESBL-producing Enterobacteriaceae showed high levels of resistance to other antibiotics like cotrimoxazole and ciprofloxacin [26, 27]. Therefore, ESBL-producing strains are multi-drug resistant bacteria thus pose challenging scenario for empirical therapy of invasive infections.…”