Prevalence and Antimicrobial Susceptibility of Extended Spectrum β-Lactamases (ESBL) Producing Escherichia coli and Klebsiella pneumoniae Isolates in a Tertiary Care Hospital in North-West India

Hooja, Saroj; N, Pal; Karadiya, Rajendra; Sharma, Rameshwar K.; Mishra, Ramesh Kumar; Maheshwari, Ramesh

doi:10.20546/ijcmas.2016.505.045

“…The proportion of ESBL-producing Enterobacteriaceae among children under 15 years (74.1%) was in agreement with the previous studies done in Addis Ababa TASH (78.57%) [36], Tertiary Care Hospital of North-West India (66.7%) [37] and in rural Ghana (68%) (38) [38]. However, our finding was higher compared to a study conducted in Burkina Faso (50.8%) [25].…”

Section: Discussionsupporting

confidence: 90%

“…In our study ESBL-producing Enterobacteriaceae were found predominantly in blood specimens (84.4%, 76/90) followed by wound/pus specimens (52.5%, 21/40), urine (50.7, 138/272) and other specimens (CSF & other body fluids, sputum, ear and eye discharge) (45.8%, 11/24). Other investigator also reported blood as a major source of ESBL-producers in Bahir-Dar Dar (84.8% in blood, 72.7% in open wound swabs) [24], Burkina Faso (75% in blood) [25], Iran (87.8% in blood, 48.5% in urine) [39], North West India (79.2.0% in blood) [37] and again in India (66.67% in blood, 54.67% in urine) [40]. This indicates that ESBL-producing Enterobacteriaceae are becoming a serious problem in the treatment of invasive bacterial infections.…”

Section: Discussionmentioning

confidence: 99%

Extended-spectrum beta-lactamase production and multi-drug resistance among Enterobacteriaceae isolated in Addis Ababa, Ethiopia

Teklu

¹

,

Negeri

²

,

Legese

³

et al. 2019

Antimicrob Resist Infect Control

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Background The global emergence and spread of extended-spectrum beta-lactamases (ESBLs) producing Enterobacteriaceae have been threatening the ability to treat an infection. Hence, this study aimed to determine the prevalence of ESBL-producing and multi-drug resistance (MDR) Enterobacteriaceae (ESBLs-E) from different clinical specimens in Addis Ababa, Ethiopia. Methods A cross-sectional study was conducted from January 1 to May 30, 2017. A total of 426 Enterobacteriaceae isolates were identified from clinical specimens. The isolates were collected from four laboratories. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disk diffusion method on Muller Hinton agar (MHA). All Enterobacteriaceae were screened for ESBLs production using cefotaxime and ceftazidime as per CLSI guideline. Each ESBL screening positive Enterobacteriaceae were confirmed by a combination disk test (CDT). Data were entered and analyzed by using SPSS version-20. Result The most frequent Enterobacteriaceae were E. coli 228 (53.5%) and K. pneumoniae 103 (24.1%). The magnitude of ESBLs-E was 57.7% (246/426). The highest frequencies of ESBLs-E were observed in blood specimesns (84.4%) and the highest ESBLs production was observed in K. pneumoniae (85.4%). The highest resistance level was seen to sulfamethoxazole-trimethoprim (77.0%), amoxicillin with clavulanic acid (71.6%), cefotaxime (62.2%), cefepime (60.3%) and ceftazidime (60.8%). The overall magnitude of multi-drug resistance (MDR) level was 68.3%. Of ESBLs-E, 96.3% of them were MDR ( P < 0.001). Conclusion There was a high prevalence of ESBLs-E and MDR isolate in Addis Ababa. Most of ESBLs-E was isolated primarily in blood and urine. The highest ESBLs production was observed among K. pneumoniae . Hence, strong infection control strategies must be implemented in hospital settings of the country.

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“…In the present study, a high prevalence of ESBL-producing Enterobacteriaceae was found in blood specimens (62.3 %), followed by urine specimens (41.2 %) and wounds (35 %). This is in line with studies conducted in Iran [ 75 ] (87.8 % in blood, 48.5 % in urine), India [ 76 ] (66.67 % in blood, 54.67 % in urine), Burkina Faso [ 67 ] (75 % in blood) and north-west India [ 77 ] (79.2.0 % in blood). However, studies conducted in Uganda [ 72 ] (64.9 % in urine, 47.4 % in pus), Bangladesh [ 78 ] (70.4 % in urine, 16.5 % in blood) and central India [ 79 ] (52.28 % in urine) reported urine specimens as the major source of ESBL-producing Enterobacteriaceae .…”

Section: Discussionsupporting

confidence: 91%

The magnitude of extended-spectrum beta-lactamase- producing Enterobacteriaceae from clinical samples in Ethiopia: a systematic review and meta-analysis

Diriba

¹

,

Awulachew

²

,

Gemede

³

et al. 2021

Access Microbiology

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Background. The rapid spread of resistance among extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae is a serious problem around the world. It results in serious clinical complications in humans and has become a global threat. Therefore, this systematic review and meta-analysis was aimed to estimate the pooled prevalence of ESBL-producing Enterobacteriaceae in different clinical samples in Ethiopia. Methods. A systematic search was conducted on PubMed, Web of Science, Embase, Google Scholar and the Cochrane Library. All identified observational studies reporting the prevalence of ESBL-producing Enterobacteriaceae from clinical samples in Ethiopia were included. Four authors independently extracted data and analysed using R software version 3.6.1 and STATA statistical software version 13. A random-effects model was computed to estimate the pooled prevalence of ESBL-producing Enterobacteriaceae in Ethiopia. Results. Of 142 articles reviewed, 14 studies that fulfilled the inclusion criteria were included in the meta-analysis. The pooled prevalence of ESBL-producing Enterobacteriaceae in the different clinical specimens in Ethiopia was 49 % (95 % CI: 39, 60). Klebsiella pneumoniae was the leading ESBL-producing Enterobacteriaceae followed by Escherichia coli and Acinetobacter baumannii with a prevalence of 74, 67 and 60 %, respectively. ESBL-producing isolates showed a high rate of resistance to cefotaxime, ceftriaxone, ceftazidime, Amoxicillin clavulanic acid (AMC), ampicillin and aztreonam. The better options for the treatment of ESBL-producing Enterobacteriaceae are amikacin and Imipenem. Conclusion. The magnitude of ESBL-producing Enterobacteriaceae in different clinical samples in Ethiopia is alarmingly high and represents a threat to human health. Hence, a coordinated effort needs to be implemented for the prevention and control of these Enterobacteriaceae .

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“…In our investigation, the majority of ESBL-producing Enterobacteriaceae were detected in blood specimens, accounting for 82% (41/50), followed by urine specimens, accounting for 59% (62/105).Blood was identified by several researchers also as a primary source of ESBLproducers. 17,18 In our study, it was observed that meropenem (96.7%), amikacin (82.1%), and cefoxitin were the main drugs susceptible to ESBL-producing isolates. This was in close agreement with study conducted by Shashwati et al 16 and Yadav et al 19 In the present study, high resistance was documented in ceftazidime (62%), followed by Ciprofloxacin (60%), Amoxyclav (52%), Gentamycin (51%), Amikacin (48%),Cefoxitin (47%) and Meropenam (39%).However in other studies ceftazidime 83.2%, cefotaxime 74.7%, ciprofloxacin 61.1% were highly resistant antibiotics.…”

Section: Discussionmentioning

confidence: 65%

Phenotypic characterization and antibiotic suceptibility patterns of extended spectrum beta-lactamase producing enterobacteriaceae

Jain

¹

,

Jain²

2023

PJMS

0

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The rise of Enterobacteriaceae strains that produce an extended spectrum b-lactamase (ESBL) has become a global concern for epidemiological surveillance and the prevention of nosocomial acquired infections in the modern era. The choice of appropriate antibiotics to be employed in the treatment of infections brought on by ESBL-producing bacteria relies greatly on the detection and identification of these ESBLs in the laboratory. Limitations in ESBL detection have aided in the unbridled emergence of bacterial resistance and constitute a major health concern. Isolation and identification of ESBL among Enterobacteriaceae by phenotypic methodswith their Antibiogram.Phenotypic techniques were used to identify ESBL-producing Enterobacteriaceae (ESBLs-E) isolates from diverse clinical samples. Kirby Baur disc diffusion technique was performed to determine antimicrobial's susceptibility.Among 212 Enterobacteriaceae isolates 124(58.3%) were positive for ESBL production. E.coli(74.5%) & K.pneumoniae (52.2%) two main isolates that produce ESBLs. Maximum ESBL producing Enterobacteriaceae isolates were obtained from blood samples 82% (41/50) followed by urine 59 % (62/105). Meropenem (96.7%), Amikacin (82.1%), and Cefoxitin were most susceptible antibiotics for ESBL-producing isolates while high resistance was observed in ceftazidime (62%), followed by Ciprofloxacin (60%). The majority of ESBLs-E was mostly found in urine and blood samples.It was observed that E.coli produced the most ESBLs. There was a high prevalence of ESBLs-E in tertiary care hospital of central India. Therefore, strong infection control strategies must be implemented in hospital settings

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Prevalence and Antimicrobial Susceptibility of Extended Spectrum β-Lactamases (ESBL) Producing Escherichia coli and Klebsiella pneumoniae Isolates in a Tertiary Care Hospital in North-West India

Cited by 5 publications

References 14 publications

Extended-spectrum beta-lactamase production and multi-drug resistance among Enterobacteriaceae isolated in Addis Ababa, Ethiopia

Extended-spectrum beta-lactamase production and multi-drug resistance among Enterobacteriaceae isolated in Addis Ababa, Ethiopia

The magnitude of extended-spectrum beta-lactamase- producing Enterobacteriaceae from clinical samples in Ethiopia: a systematic review and meta-analysis

Phenotypic characterization and antibiotic suceptibility patterns of extended spectrum beta-lactamase producing enterobacteriaceae

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