scholarly journals Molecular Characterization of invasive Enterobacteriaceae from Pediatric Patients in Central and Northwestern Nigeria

2020 ◽  
Author(s):  
Carissa Duru ◽  
Grace M Olanipekun ◽  
Vivian Odili ◽  
Nicholas J Kocmich ◽  
Amy Rezac ◽  
...  
Keyword(s):  
Resistance Genes ◽  
Treatment Options ◽  
Bloodstream Infections ◽  
Multidrug Resistant ◽  
Diffusion Method ◽  
Esbl Production ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
High Prevalence ◽  
Resistance Rates

AbstractBackgroundBacteremia is a leading cause of death in developing countries but etiologic evaluation is infrequent and empiric antibiotics are not evidence-based. Very little is known about the types of extended-spectrum β-lactamases (ESBL) in pediatric bacteremia patients in Nigeria. We evaluated the patterns of ESBL resistance in children enrolled into surveillance for community acquired bacteremic syndromes across health facilities in Central and Northwestern Nigeria.MethodBlood culture from suspected cases of sepsis from children age less than 5 years were processed using automated Bactec® incubator System from Sept 2008-Dec 2016. Enterobacteriacea were identified to the species level using Analytical Profile Index (API20E®) identification strip and antibiotic susceptibility profile was determined by the disc diffusion method. The multidrug resistant strains were then screened and confirmed for extended spectrum beta lactamase (ESBL) production by the combination disc method as recommended by Clinical and Laboratory Standard Institute (CLSI). Real time PCR was used to elucidate the genes responsible for ESBL production characterize the resistance genesResultOf 21,000 children screened from Sept 2008-Dec 2016, 2,625(12.5%) were culture-positive. A total of 413 Enterobacteriaceae available for analysis were screened for ESBL. ESBL production was detected in 160/413(38.7%), comprising Klebsiella pneumoniae 105/160(65.6%), Enterobacter cloacae 21/160(13.1%), Escherichia coli 22/160(13.8%), Serratia species 4/160(2.5%), Pantoea species 7/160(4.4%) and Citrobacter species 1/160(0.6%). Of the 160 ESBL-producing isolates, high resistance rates were observed among ESBL-positive isolates for Ceftriaxone (92.3%), Aztreonam (96.8%), Cefpodoxime (96.25%), Cefotaxime (98.75%) and sulphamethoxazole-trimethoprim (90%), while 87.5 %, 90.63%, and 91.87% of the isolates were susceptible to Imipenem, Amikacin and Meropenem respectively. Frequently detected resistance genes were blaTEM 83.75%) (134/160), and, blaCTX-M 83.12% (133/160) followed by blaSHV genes 66.25% (106/160). Co-existence of blaCTX-M, blaTEM and blaSHV was seen in 94/160 (58.8%), blaCTX-M and blaTEM in 118/160 (73.8%), blaTEM and blaSHV in 97/160 (60.6%) and blaCTX-M and blaSHV in 100/160 (62.5%) of isolates tested.ConclusionOur results indicate a high prevalence of ESBL resistance to commonly used antibiotics in Enterobacteriaceae isolates from bloodstream infections in children in this study. Careful choice of antibiotic treatment options and further studies to evaluate transmission dynamics of resistance genes could help in the reduction of ESBL resistance in these settings.

scholarly journals Beta Lactamase Genes of Extended Spectrum Beta Lactamase Producing Escherichia coli from Anorectal Sepsis Cases in Bangladesh

2016 ◽  
Vol 30 (1-2) ◽  
pp. 23-29
Author(s):  
Sheikh Shahidul Islam ◽  
Md Abdul Malek ◽  
AKM Fazlul Haque ◽  
Kaisar Ali Talukder ◽  
Marufa Zerin Akhter
Keyword(s):  
Multidrug Resistant ◽  
Diffusion Method ◽  
Pcr Analysis ◽  
Beta Lactamase ◽  
Disc Diffusion ◽  
Esbl Production ◽  
Disc Diffusion Method ◽  
Extended Spectrum Beta Lactamase ◽  
E Coli ◽  
Extended Spectrum

A microbiological study was carried out to determine the prevalence of extended spectrum beta lactamase (ESBL) producing E. coli in anorectal sepsis patients in Bangladesh. One hundred specimens of pus, swab, or exudates from anorectal sepsis cases were studied. All the 61 isolates of E. coli were found to be highly resistant to most of the drugs used. Among these, 14 multidrug resistant E. coli were examined for ESBL production by double disc diffusion method. Six of these were found to be ESBL positive. PCR analysis revealed that 3 of the 6 isolates had coexistence of blaSHV, blaOXA and blaCTXM-1 genes. Two of the isolates had only blaSHV gene, whereas 1 isolate had a combination of blaTEM and blaSHV genes. Three of these were resistant to all the drugs tested, while two were sensitive to getamicin and one to ciprofloxacin. None of the E. coli strains possessed blaCTXM-2, blaCTXM-8, blaCTXM-9, and qnr genes.Bangladesh J Microbiol, Volume 30, Number 1-2,June-Dec 2013, pp 23-29

scholarly journals Detection of Multidrug-resistant Extended-spectrum Beta-lactamase-producing Enterobacteria from Community Infections in the city of Reynosa, Tamaulipas Mexico

2020 ◽  
Author(s):  
Eduardo Cruz-González ◽  
Esther Ramírez-Moreno ◽  
Jessica Ortega-Balleza ◽  
Itzel Heredia-Mireles ◽  
Imelda Ramirez-Puente ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Multidrug Resistant ◽  
Diffusion Method ◽  
Esbl Production ◽  
Genetic Transmission ◽  
Beta Lactamases ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
Extended Spectrum Beta Lactamases ◽  
The City

Abstract Production of extended spectrum beta-lactamases (ESBL) is one of the main problems related to antimicrobial resistance worldwide, with the CTX-M, TEM and SHV types standing out as the most prevalent. These enzymes are usually related to plasmids which facilitates their horizontal genetic transmission. In the northeast region of Tamaulipas their clinical prevalence is unknown. Therefore, the aim of this work was to define the molecular epidemiology of ESBL-producing Enterobacteriaceae in clinical strains collected in Reynosa Tamaulipas, Mexico. A selection of 123 Enterobacteriaceae strains from different clinical patients were collected from August 2018 to December 2019. These strains were phenotypically identified by double disk synergy tests (DDST) and subsequently subjected to polymerase chain reaction for the detection and amplification of the blaTEM, blaSHV, blaCTX−M−1, blaCTX−M−2, blaCTX−M−9 and blaCTX−M−8/25 genes. Lastly, antimicrobial resistance profiles were determined by plate diffusion method and their capacity to transfer this sort of resistance by conjugation was assessed. Our results showed a prevalence of 48.78% (60/123) of ESBL-producing enterobacteria, with the blaTEM and blaCTX−M−1 genes most commonly detected in 76.67% (46/60) and 58.33% (35/60), respectively. Additionally, a 68.33% (41/60) of these ESBL-producing Enterobacteriaceae were multidrug-resistant, while 51.67% (31/60) were able to transfer some genes related to ESBL production, being blaCTX−M−1 the most common. This is the first study in the region that evaluates ESBL production in clinical Enterobacteriaceae strains, as well as the content of genes related to this phenotype and the ability to transfer this type of antimicrobial resistance.

scholarly journals Coproduction of Extended Spectrum, AmpC and Metallo β- Lactamases in Pseudomonas aeruginosa Isolates from a Super Speciality Center

2021 ◽  
Vol 10 (10) ◽  
pp. 176-184
Author(s):  
Ashna Bhasin Poonam Loomba ◽  
Abha Sharma Bibhabati Mishra ◽  
Ashish Bajaj
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Treatment Options ◽  
Multidrug Resistant ◽  
Clinical Isolates ◽  
Diffusion Method ◽  
Beta Lactamase ◽  
Beta Lactam ◽  
Disk Diffusion Method ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum

Pseudomonas aeruginosa (P. aeruginosa) is one of the leading causes of hospital as well as community acquired infections. They’re strenuous to treat as most of isolates exhibit various degrees of beta- lactamase mediated resistance to majority of the beta-lactam antibiotics. Single isolate can express multiple β- lactamase enzymes, further limiting the treatment options. Therefore, this study was outlined to research the coexistence of various beta-lactamase enzymes in clinical isolates of P. aeruginosa. The aim of the study was to detect the co-prevalence of Extended Spectrum Beta lactmases (ESBL), AmpC and Metallo β-Lactamases (MBL) in Pseudomonas aeruginosa isolates from a superspeciality center. Fifty clinical isolates of P. aeruginosa were tested for the presence of AmpC beta-lactamase, extended spectrum beta- lactamase (ESBL) and metallo beta-lactamase (MBL) enzyme. Discernment of AmpC beta-lactamase was performed by disk antagonism while ESBL detection was done by the combined disk diffusion method as per Clinical and Laboratory Standards Institute (CLSI) guidelines and MBL were detected by the Imipenem EDTA disk potentiation test. Eleven of 50 (22%) isolates were confirmed to be positive for AmpC and Extended spectrum beta lactamases. Co-production of AmpC along side ESBL and MBL was reported in 12 % isolates. The study shows the high prevalence of multidrug resistant P. aeruginosa producing beta-lactamase enzymes of diverse mechanisms. Consequently, formulation of a correct antibiotic policy and taking measures to restrict the indiscriminative use of cephalosporins and carbapenems should be taken to mitigate the emergence of this multiple beta-lactamase producing pathogens.

scholarly journals Bloodstream infections in children caused by extended spectrum beta-lactamase-producing Klebsiella pneumoniae

2012 ◽  
Vol 64 (4) ◽  
pp. 1339-1347
Author(s):  
Deana Medic ◽  
Vera Gusman ◽  
Mira Mihajlovic-Ukropina ◽  
Zora Jelesic ◽  
Biljana Milosavljevic
Keyword(s):  
Klebsiella Pneumoniae ◽  
Bloodstream Infections ◽  
Multidrug Resistant ◽  
Beta Lactamase ◽  
Antimicrobial Drugs ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
High Prevalence ◽  
Vojvodina Province

The aim of this study is to determine the prevalence of extended spectrum beta-lactamase (ESBL) producing Klebsiella pneumoniae strains isolated from blood in children and their susceptibility to antimicrobial drugs commonly used in the therapy. The study was conducted at the Institute of Public Health of Vojvodina Province, Serbia, in a two-year period, from January 2009 to December 2010. A total of 424 non-duplicate strains were isolated from the blood of pediatric patients hospitalized in various wards in the Institute of Health Care of Children and Youth of Vojvodina Province. Fifty isolates of Klebsiella pneumoniae were reported. The frequency of isolation of Klebsiella pneumoniae was 27/222 (12.2%) and 23/202 (11.3%) isolates in 2009 and 2010, respectively. There was a high prevalence of ESBL-producing Klebsiella pneumoniae, 76% (38/50), and 17 isolates (44.7%) were multidrug resistant (MDR). Further drug resistance surveillance in hospitals and the molecular characterization of ESBL-positive isolates in our country is necessary.

scholarly journals Presence of different beta-lactamase classes among clinical isolates of Pseudomonas aeruginosa expressing AmpC beta-lactamase enzyme

2010 ◽  
Vol 4 (04) ◽  
pp. 239-242 ◽  
Author(s):  
Supriya Upadhyay ◽  
Malay Ranjan Sen ◽  
Amitabha Bhattacharjee
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Treatment Options ◽  
Clinical Isolates ◽  
Diffusion Method ◽  
Beta Lactamase ◽  
Beta Lactam ◽  
Disk Diffusion Method ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
Enzyme Detection

Introduction: Infections caused by Pseudomonas aeruginosa are difficult to treat as the majority of isolates exhibit varying degrees of beta-lactamase mediated resistance to most of the beta-lactam antibiotics. It is also not unusual to find a single isolate that expresses multiple β-lactamase enzymes, further complicating the treatment options. Thus the present study was designed to investigate the coexistence of different beta-lactamase enzymes in clinical isolates of P. aeruginosa. Methodology: A total of 202 clinical isolates of P. aeruginosa were tested for the presence of AmpC beta-lactamase, extended spectrum beta-lactamase (ESBL) and metallo beta-lactamase (MBL) enzyme. Detection of AmpC beta-lactamase was performed by disk antagonism test and a modified three-dimensional method, whereas detection of ESBL was done by the combined disk diffusion method per Clinical and Laboratory Standards Institute (CLSI) guidelines and MBL were detected by the Imipenem EDTA disk potentiation test. Results: A total of 120 (59.4%) isolates were confirmed to be positive for AmpC beta-lactamase. Among them, 14 strains (7%) were inducible AmpC producers. Co-production of AmpC along with extended spectrum beta-lactamase and metallo beta-lactamase was reported in 3.3% and 46.6% isolates respectively. Conclusion: The study emphasizes the high prevalence of multidrug resistant P. aeruginosa producing beta-lactamase enzymes of diverse mechanisms. Thus proper antibiotic policy and measures to restrict the indiscriminative use of cephalosporins and carbapenems should be taken to minimize the emergence of this multiple beta-lactamase producing pathogens.

Prevalence of Extended Spectrum Beta-Lactamase Producing Enterobacteriaceae Isolated From Clinical Samples in Illorin Metropolis, Kwara State Nigeria

2021 ◽  
Vol 6 (2) ◽  
pp. 1-7
Author(s):  
Eze EM
Keyword(s):  
Escherichia Coli ◽  
Health Care ◽  
Health Care Facilities ◽  
Diffusion Method ◽  
Klebsiella Pneumonia ◽  
Beta Lactamase ◽  
Esbl Production ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
Significant Difference

Background: This study investigated the prevalence of extended spectrum beta-lactamase producing enterobacteriaceae in Illorin metropolis using standard methods. The prevalence of ESBLs is increasingly being reported worldwide, and it varies according to geographic location and is directly linked to the use and misuse of antibiotics extended spectrum lactamases (ESBLs) are a major challenge in hospitalized patients worldwide and cause epidemic outbreaks in health care facilities, spreading in the community leading to various infections. Objectives: Screen for the extended spectrum β-lactamase producing Enterobacteriaceae and also determine the prevalence of ESBL producing Enterobacteriaceae in relation to gender, age and sample source. Methods: One hundred and sixty eight samples collected from routine clinical specimen such as high vagina swabs, urine, urethra swabs and wound swabs and sputum from October to December 2018 were studied. Fifty two enterobacteriaceae were isolated using spread plate method on macConkey and Cystein lactose electrolyte deficient media. The organisms were Klebsiella pneumoniae, Escherichia coli, Salmonella sp, Shigella sp, and Proteus sp. The isolates were subjected to antibiotic susceptibility testing using modified Kirby-Bauer standardized disc diffusion method. The antibiotics used were ceftazidine (30ug), cefuroxime (30ug), gentamicin (10ug), ciprofloxacin (5ug), ofloxacin 5ug, amoxicillin/clavulanate 30ug, nitrofurantoin 30ug and ampicillin 10ug. Ceftazidime showed a susceptibility percentage of 84.6%,, cefuroxime 61.5%, gentamicin 71.2% ciprofloxacin 46.2%, ofloxacin 51.9%, augmentin 61.5%, nitrofurantoin 71.2% and ampicillin, 44.2% with a significant difference (P< 0.05).Extended spectrum beta-lactamase ESBL, production by clinical and laboratory standards institute (CLSI) methods showed that 15(28.9%) of isolates belonging to the genera Escherichia, Klebsiella and Proteus expressed ESBL production. The order of ESBL production by the isolates were Escherichia coli 9 (17.3%), Klebsiella pneumonia 5(9.3%) and Proteus 1(1.9%). Thus, attention needs to be given by health care personnel’s to ESBL producing organisms in order to reduce the spread.

scholarly journals Effect of ceftiofur cessation and substitution with lincomycin-spectinomycin on extended-spectrum-beta-lactamase/AmpC genes and multidrug resistance in E. coli from a Canadian broiler production pyramid

2019 ◽  
Author(s):  
L. Verrette ◽  
J. M. Fairbrother ◽  
M. Boulianne
Keyword(s):  
Multidrug Resistance ◽  
Multidrug Resistant ◽  
Poultry Production ◽  
Extended Spectrum Beta Lactamase ◽  
E Coli ◽  
Extended Spectrum ◽  
High Prevalence ◽  
Cephalosporin Resistance ◽  
One Year ◽  
The Impact

AbstractCeftiofur, a cephalosporin antimicrobial, was used systematically in Canadian hatcheries for many years to prevent early mortality in chicks leading to a high prevalence of cephalosporin resistance in Escherichia coli in chickens. Preventive use of ceftiofur in hatcheries ceased in 2014. We examined the effect of ceftiofur cessation and replacement with lincomycin-spectinomycin at the hatchery on the proportion of E. coli positive for extended-spectrum β-lactamase (ESBL) and AmpC β-lactamase related genes, and on the multidrug resistance profiles of ESBL/AmpC positive E. coli in broilers and their associated breeders, at one year post-cessation. For indicator E. coli from non-enriched media, a significant decrease post-cessation in the proportion of samples harboring E. coli isolates positive for blaCMY-2 and/or blaCTX-M was observed. In contrast, following enrichment in medium containing ceftriaxone (1mg/L) to facilitate recovery of ESBL/AmpC β-lactamase producing E. coli colonies, both pre- and post-cessation, 99% of the samples harbored E. coli positive for blaCMY-2 or blaCTX-M. Flocks receiving lincomycin-spectinomycin after cessation of ceftiofur showed a significantly greater non-susceptibility to aminoglycoside, folate inhibitor, phenicol, tetracycline and possible extensively drug resistant E. coli compared to those receiving ceftiofur or no antimicrobial at hatchery. This study clearly demonstrates an initial decrease in ESBL/AmpC positive E. coli following the cessation of ceftiofur in hatchery but an increase in multidrug resistant E. coli following replacement with lincomycin-spectinomycin.ImportanceAntimicrobial resistance is a global problem. The antimicrobial ceftiofur has been used worldwide for disease prevention in poultry production resulting in a greatly increased resistance to this antimicrobial important in poultry and human medicine. Our study examines the impact of ceftiofur cessation and its replacement with the antimicrobial combination lincomycin-spectinomycin, a common practice in the industry. Our study demonstrated a decrease in ceftiofur resistance after the cessation of its use, although the resistance genes remain ubiquitous in all phases of poultry production, showing that poultry remains a reservoir for ceftiofur resistance and requiring continued vigilance. We also observed a decrease in multidrug resistance after cessation of ceftiofur although the contrary finding following use of lincomycin-spectinomycin indicates that the use of these antimicrobials should be questioned. Reduced resistance to ceftiofur in poultry may translate to better treatment efficacy, decreased morbidity, mortality, duration and cost of hospitalization in humans.

scholarly journals ESBL Producers in Gram Negative Isolates from Clinical Samples

2020 ◽  
Vol 14 (3) ◽  
pp. 2027-2032
Author(s):  
Mita D. Wadekar ◽  
J.V. Sathish ◽  
C. Pooja ◽  
S. Jayashree
Keyword(s):  
Treatment Options ◽  
Multidrug Resistant ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Beta Lactamase ◽  
Beta Lactam ◽  
Gram Negative ◽  
Extended Spectrum Beta Lactamase ◽  
Beta Lactam Antibiotics ◽  
Esbl Producers

Resistance to beta lactam antibiotics is the most common cause for beta-lactamase production. Increasing number of extended spectrum beta-lactamase (ESBL) producers has reduced the treatment options which resulted in emergence of multidrug resistant strains, treatment failure and hence increased mortality. To detect phenotypically, ESBL producers in Gram negative isolates from different samples and to know their susceptibility pattern. A retrospective study of Gram negative isolates was conducted. Total of 521 isolates were isolated from various samples. They were processed and identified by standard procedures. The antibiotic susceptibility testing was performed by Kirby- Bauer disc diffusion method using CLSI guidelines. ESBL was detected by combination disk test. A total of 521 Gram negative isolates were isolated which included E. coli, Klebsiella pneumoniae, Citrobacter spp., Enterobacter spp., Proteus spp. and Acinetobacter spp. Pseudomonas aeruginosa. Of 521 isolates tested, ESBL was detected in 329 (63.1%) isolates. These isolates showed maximum susceptibility to piperacillin- tazobactam (86%) followed by imipenem (78.4%), amikacin (63.5%), cotrimoxazole (54.4%), ciprofloxacin (51%), amoxi-clav (44.9%), cefepime (44.1%), gentamicin (38.9%), cefoxitin (34.9%) and ampicillin (19.1%). ESBL producers which are resistant to beta lactam antibiotics have become a major problem. Detection of these beta-lactamase enzymes by simple disk method and its reporting will help clinicians in prescribing proper antibiotics.

scholarly journals Extended Spectrum Beta Lactamase (ESBL) Producing Klebsiella pneumoniae , a therapeutic challenge.

2015 ◽  
Vol 13 (1) ◽  
pp. 22-25
Author(s):  
Raina Chaudhary ◽  
Sabita Bhatt Bhatt ◽  
Eva Piya
Keyword(s):  
Klebsiella Pneumoniae ◽  
Multidrug Resistant ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Gram Negative Bacteria ◽  
Beta Lactamase ◽  
Esbl Producer ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
Sensitivity Pattern

Introduction: Klebsiella pneumoniae is one of the most common Gram negative bacteria encountered byclinicians worldwide as a cause of infections in human. Most of the infections are acquired in hospital settingtherefore, it is reported to be the amongst the 10 most common nosocomial pathogen in various studies. Nowadays,Klebsiella pneumoniae infections are complicated by increase in Extended Spectrum Beta Lactamase (ESBL)producing isolates. Therefore, this study is being conducted with the objective to fi nd out the prevalence ofESBL producing Klebsiella pneumoniaein various clinical samples and to fi nd out there sensitivity pattern.Methods: A total of 100 Klebsiella pneumoniae were isolated from various samples during the period of April2013 to November 2013 in Microbiology Unit of Shree Birendra Hospital. All the isolates were identifi ed withtheir sensitivity pattern according to standard methodology. Combination disc diffusion method was followedfor identifi cation of ESBL.Results: Out of total 100 isolates of Klebsiella pneumoniae21% were ESBL producer.ESBL producer isolatesshowed 100% sensitivity to Imepenem followed by Amikacin 57.1% and Chloramphenicol 47.6%. All theESBL isolates were resistant to both Cefotaxime and Ceftazidime.Conclusions: ESBL producer Klebsiella pneumoniae isolates were multidrug resistant. Continuous surveillanceand timely intervention with discouraging the use of cephalosporin group of antibiotics is mandatory.doi:  http://dx.doi.org/10.3126/mjsbh.v13i1.12996 

scholarly journals High Prevalence of Multidrug-Resistant and Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae: A Cross-Sectional Study at Arsho Advanced Medical Laboratory, Addis Ababa, Ethiopia

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Adane Bitew ◽  
Estifanos Tsige
Keyword(s):  
Multidrug Resistance ◽  
Multidrug Resistant ◽  
Resistance Rate ◽  
Medical Laboratory ◽  
Beta Lactamase ◽  
Drug Resistant ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
High Prevalence ◽  
Vitek 2

Background. Multidrug-resistant Enterobacteriaceae particularly extended-spectrum beta-lactamase producers have become a major public health threat. Despite efforts to limit their spread, rates of multidrug-resistance members of the Enterobacteriaceae continue to increase throughout the world causing increased morbidity and mortality and raised costs for medical care. Objective. The aim of this study was to determine the prevalence of multidrug resistance and extended-spectrum β-lactamase-producing Enterobacteriaceae. Methods. Four hundred forty Enterobacteriaceae isolates from outpatients referred to Arsho Advanced Medical Laboratory were identified and assessed for their antimicrobial resistance pattern by using the automated VITEK 2 compact system. Extended-spectrum β-lactamase production was determined by the VITEK 2 automated compact system using the extended-spectrum β-lactamase test panel as per the instruction of the manufacturer. Results. The overall resistance rates of Enterobacteriaceae against cephalosporins, aminoglycosides, and fluoroquinolones were high. Nitrofurantoin with a resistance rate of 14.3% and piperacillin/tazobactam combination with a resistance rate of 17.3% were better active against this group of Gram-negative bacteria. Out of 440 isolates of Enterobacteriaceae, 42.1% were multidrug-resistant of which 34.3% and 8.95% were extensively drug-resistant and pan-drug resistant, respectively. Among 185 multidrug-resistant Enterobacteriaceae, 63.9% of the isolates produced extended-spectrum β-lactamase of which 75.4%, 19.5%, 1.7%, 2.5%, and 0.8% were E. coli, K. pneumoniae, C. freundii, E. cloacae, and P. mirabilis, respectively. Conclusions. The present study demonstrated high prevalence rates of multidrug-resistant and extended-spectrum-beta-lactamase-producing Enterobacteriaceae. In order to combat these problems, infection control strategy and proper antibiotic policies should be formulated.

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