Prevalence and Risk Factors associated with Extended Spectrum Beta Lactamase Producing Escherichia coli and Klebsiella pneumoniae Isolates in Hospitalized Patients in Kashan (Iran)

Abstract

IntroductionProduction of extended spectrum beta lactamase (ESBL) is an important mechanism of antimicrobial resistance in Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae) isolates. This study was performed to determine the prevalence and risk factors associated with ESBL producing strains of E. coli and K. pneumoniae.MethodsIn this cross-sectional study, 250 strains (134 E. coli and 116 K. pneumoniae) were obtained, and ESBL producing isolates were detected by the combination disk test in Shahid Beheshti Hospital in Kashan, Iran, from February 2012 to June 2013. Antimicrobial resistance was screened by the disk diffusion method and was confirmed by E-test. Furthermore, risk factors of ESBL producing E. coli and K. pneumoniae microorganisms were determined. Data were analyzed by SPSS version 16, using descriptive statistics, chi-squared, independent-samples t-test, and logistic regression analysis.ResultsOne hundred and two (40.8%) of all strains were ESBL producers, of which 54 (52.9%) were E. coli and 48 (47.1%) were K. pneumoniae (p = 0.86). Furthermore, 40.3% of E. coli and 41.4% of K. pneumoniae isolates were ESBL producers (p = 0.86). The most antimicrobial resistance was to ampicillin, and no imipenem resistance was detected. Risk factors for ESBL producing E. coli included admission duration exceeding 7 days (p = 0.011) and antibiotic use in the last month (p < 0.001), and the associated risk factor for ESBL producing K. pneumoniae was antibiotic use during the recent month (p = 0.002).ConclusionThis study identified a relatively high prevalence of ESBL production among E. coli and K. pneumoniae strains. Furthermore, anti-bimicrobial use and admission duration were risk factors for ESBL producing isolates. Therefore, more comprehensive investigations are needed for the development of new strategies to control the dissemination of these microbes.

Dissemination of multidrug-resistant, Class I and II integrons and molecular typing of CTX-M-producing Klebsiella pneumoniae

“…[ 23 ] Although in most of the studies, the ESBL prevalence was higher than our study. [ 23 24 25 26 ]…”

Bacterial resistance to antibiotics and associated factors in two hospital centers in Lebanon from January 2017 to June 2017

“…However other studies have reported that age is not a factor in determining antibiotic resistance in patients with febrile UTI specifically, or in patients generally [ 8 , 9 ]. An Iranian study also found no significant association between age and the likelihood of having extended-spectrum beta-lactamase (ESBL)-producing bacteria [ 10 ].…”

“…Several studies have investigated the relationship between gender and antibiotic resistance. An Iranian study found no association between gender and ESBL production [ 10 ], and an American study showed no difference in the susceptibility patterns of E. coli causing UTI in men and women [ 11 ]. However, a German study found that uropathogenic E. coli were more antibiotic-resistant in women [ 12 ].…”

Environmental impact assessment of Gonabad municipal waste landfill site using Leopold Matrix

“…Various methods have been devised and used to create balance and harmony between human activity and the environment ( 1 – 5 ). The purpose of using these methods is modification and minimization of the negative effects and consequences of human activities by using a set of protective and reform measures ( 6 , 7 ). An environmental impact assessment (EIA) is one of the best ways to assess the impacts of sections or activities of a project on the components of the environment by identifying and understanding the importance of the environment; finally, according to the its results, it provides solutions to create greater consistency ( 8 , 9 ).…”