Extended Spectrumβ-Lactamases among Gram-Negative Bacterial Isolates from Clinical Specimens in Three Major Hospitals in Northern Jordan

Abstract

Background and Objectives. Extended spectrum β-lactamase (ESBL) production is increasing all over the world, and organisms other than E. coli and K. pneumoniae are acquiring this character. ESBL production is detectable by automation, E-test, double disk diffusion (DDD), and PCR. This study aimed to determine the prevalence of ESBL production among clinical isolates of gram-negative rods, and to evaluate the effectiveness of augmentation of clavunate with Cefotaxime, Ceftazoxime, Aztreonam, Ceftriaxone, and Cefpodoxime in detecting ESBL production. Methods. 472 clinical gram-negative isolates identified by standard methods were tested for ESBL-production by (DDD) method using six cephalosporins and amoxicillin-clavulinate discs. Results. 108/472 (22.9%) of the isolates were ESBL producers, and were prevalent in tertiary care hospitals. 88.2% of E. cloacae, 71.4% of K. pneumoniae, 28.6% of K. oxytoca, 12.5% of C. freundii, 11.1% of A. calcoacceticus, and 10.8% of E. coli were ESBL producers. The DDD test demonstrated some variations in the efficacy of the different cephalosporins in detecting all the ESBL producers. The inclusion of ceftizoxime discs increased the efficacy of the test. It is concluded that ESBL-producing bacteria were prevalent among our hospitalized patients, and involved genera other than Klebsiella and Escherichia, and the inclusion of ceftizoxime increased the efficacy of ESBL detection by the DDD test.

Bacteriology and antimicrobial susceptibility of ESBLs producers from pus in patients with abdominal trauma associated intra-abdominal infections

“…That study demonstrated a remarkable and worrisome increase in ESBLs producing E. coli isolates (around 30 %) and K. pneumoniae isolates (around 28 %) [13]. Another study from hospitals of Jordan recognized that the prevalence of ESBLs producing E. coli and K. pneumoniae was 10.8 and 34.0 %, respectively [14]. A similar study from Vietnam has also detected ESBLs in 48.1 % of gram-negative bacilli associated IAIs [3].…”

Molecular characterization of ESBL gene in Citrobacter spp. and antibacterial activity of omega-3 against resistant isolates

“…Subsequently, using the results of testing with cefotaxime, ceftazidime, ceftriaxone, and aztreonam (30 µg of each), β-lactam resistant isolates (ESBL Production) were initially screened out according to [14]. Their presence were then confirmed by the disk approximation test according to [15]. Herein, any augmentation which appear to increase the diameter of the inhibition zone between the central amoxi-clav disk and any of the surrounding disks for the cefotaxime, ceftazidime, ceftriaxone, and aztreonam that was distributed around the amoxi-clav disk was considered as positive for the presence of ESBL Production.…”

Antibiotic Resistance Patterns of Multidrug Resistant and Extended-Spectrum Β-Lactamase Producing Eshcherichia Coli Urinary Isolates at Queen Rania Al-Abdullah Hospitalfor Children, Jordan

“…This study found that ESBL-producers isolates were as high as 50.8%, which is comparable with other studies from Jordan 50.3% 37 or Pakistan (54% -57.4%) [38][39][40] , but higher than studies from India (40%) 17 , Tanzania (39.1%) 41 , Iran (21% and 35%) 42,43 , Saudia Arabia (24.5% in children) 44 , Lebanon 17.7% (23.5% from hospitalized children with UTIs and 14.1% from community UTIs), and from other studies in Jordan 10.8%. 45 The prime factors for increasing resistant to 3rd generation cephalosporin or other broad spectrum antibiotics are; the over prescriptions of these antibiotics beside the lack of routine screening for ESBL-producer E.coli or isolation guidelines for the infected patients. 46 38,40,41 ) havebeen also found in different studies.…”