EXTENDED SPECTRUM β-LACTAMASES IN ENTERIC GRAM-NEGATIVE BACILLI: RELATED TO AGE AND GENDER
Abstract
Background: Extended Spectrum β-Lactamases (ESBLs)-producing strains of Enterobacteriaceaehave emerged as a major problem in hospitalized as well as community based patients. Infections
due to ESBLs-producers range from uncomplicated urinary tract infection to life threatening sepsis
.The objective of this study was to find out the prevalence of ESBLs-producing Gram- negative
bacilli among clinical isolates. Methods: This descriptive study was conducted at the Microbiology
department of Fauji Foundation Hospital, Rawalpindi over a period of two years (March 2004-April
2006). Six hundred and nine isolates of Enteric Gram-negative rods from various samples were
tested for ESBLs- production by double disc synergy test. In 176 ESBLs-producing isolates, source
of samples in term of indoor/outdoor was analyzed. In 165 ESBLs-producing isolates, patients'
gender and age was analysed from 3 months to 70 years. Results: The ESBLs-producing isolates
were more commonly isolated from indoor patients (88.1%) as compared to outdoor patients
(11.9%). Escherichia coli was found to be most prevalent organism in indoor patients while
Klebsiella pneumoniae, was the most prevalent organism in outdoor patients. ESBLs were most
commonly isolated from female patients (64.3%) suffering from urinary tract infections ((41.5%), as
compared to male patients (35.7%) in which the organisms were most commonly isolated from pus
samples (54.2 %). ESBLs-producing Enteric Gram-Negative rods were most frequent at later part of
life where they were most common (27.9%) at 61-70 years, followed by 41-50 years of age group
(20.0%). Another peak (13.3%) was also seen at younger age group (11-20 years). The least
prevalence (5.5%) was seen in two age groups (0-10 and 31-40 yrs). In case of female patients,
ESBLs-producing EGNR were most frequently (29.2%) isolated from middle age group (41-50
years) followed by later age groups (51-60 and 61-70 years, (15.1% and 25.5%). Conclusions:
Considering the high prevalence of ESBLs in Enteric Gram-negative rods, it is suggested that all
such isolates should be tested for the production of ESBLs in the routine microbiology laboratory.
Key Words: Extended-Spectrum Beta-lactamases, Enterobacteriaceae, Enteric Gram-Negative
rods, Escherichia coli, Klebsiella pneumoniae, Enterobacter spp
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