scholarly journals E-COLI AND KLEBSIELLA PNEUMONIAE

2015 ◽  
Vol 22 (10) ◽  
pp. 1362-1366
Author(s):  
Fazli Bari ◽  
Muhammad Akram ◽  
Hamidullah Shah ◽  
Muhammad Imtiaz Shafiq

Objectives: To evaluate extended spectrum betalactamase (ESBL) in E.coli andKlebsiella pneumoniae in bacterial cultures and its frequency at LRH. Study Design: Crosssectional analytical study. Setting: Lady Reading Hospital, Peshawar. Period: June 2013 toDecember 2013. Methodology: Total of 1037 bacterial isolates including 614 E.coli and 423 ofKlebsiellapneumoniae were evaluated. All cases were subjected to double disc diffusion methodfor ESBL detection using amoxacilln-clavulanic acid and a third generation cephalosporin asall ESBLs are hydrolysed by clavulanic acid. The data were analysed using SPSS-16. Results:Out of 1037 cases five ninety two (55%) were males and four fourty five (45%) were females. Ofthese, E. Coli were 614 (59.2%) and K. Pneumoniae were four twenty three (40.8%). Of these1037 isolates, four hundred & ninety five(47.7%) tested positive for ESBL enzyme. Frequencyof ESBL positivity in E.coli isolates was 264 (43%) and in Klebsiellapneumoniae isolates was231 (54.6%).Frequency of ESBL in pus was 34.3%(152/395),in urine, it was 31.8%(141/368),in blood it was 28.6%(127/233) and in sputum it was 5.1% (23/41). Unit wise frequency ofESBL was surgical & allied 24.6% (109/283), medical and allied 21.4%( 95/241), paediatrics18.5% (82/203), obstetrics & gynaecology 23.2%( 103/178) and outpatients 12.1 %(54/132).No significant correlation between ESBL positivity, gender, unit or specimen was found.Conclusion: ESBL positive isolates of E.coli and K.pneumoniaeshould be properly detected inroutine laboratory workflow to avoid unnecessary use of otherwise effective antibiotics.Theseresults indicate that such organisms are highly prevalent in our Hospital and need immediateinfection control measures to reduce their further spread.

2014 ◽  
Vol 17 (4) ◽  
pp. 657-664 ◽  
Author(s):  
P. Brodzki ◽  
M. Bochniarz ◽  
A. Brodzki ◽  
Z. Wrona ◽  
W. Wawron

AbstractThe aim of this study was to determine the percentage of participation of particular species of microorganisms, isolated from the uterus of cows with endometritis and from cows without inflammatory lesions of the uterus, in the same postpartum period. The aim of the study was also to examine how long after parturition non-treated endometritis persists. Moreover, antibiotic susceptibility tests were carried out of the bacterial isolates dominating in the uterus. Forty cows were included in the study: 20 cows with endometritis (experimental group) and 20 cows without any inflammatory condition of the uterus (control group). The material for cytological and bacteriological tests was collected on the 5th, 26th, 40thand 60thday after parturition, using an intrauterine brush adapted for cows. The total number of collected isolates was 149, including 120 isolates from the uterus of cows with endometritis and 29 isolates from the uterus of cows without endometritis. The following species of microorganisms were isolated from the material collected from cows with endometritis: T. pyogenes (49.2%), E.coli (22.5%), F. necrophorum (11.7%), Staphylococcus sp. (6.7%), B. melaninogenicus (5.8%), and Streptococcus sp. (4.1%). The participation percentage of particular species of bacteria in the material collected from the uterus of cows without endometritis was as follows: T. pyogenes (27.6%), E.coli (24.2%), Staphylococcus sp. (20.7%), Streptococcus sp. (20.7%), B. melaninogenicus (3.4%) and F. necrophorum (3.4%). The highest percentage of T. pyogenes isolates was susceptible to ceftiofur (89.6%); cefoperazone (85.1%) and amoxicillin combined with clavulanic acid (79.1%). E. coli isolates were most susceptible to amoxicillin combined with clavulanic acid (100%), cefoperazone (94.1%) and oxytetracycline (82.3%).


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Costa ◽  
A Cara d'Anjo ◽  
M Cardo ◽  
A Leite

Abstract Antimicrobial resistance (AMR) poses a threat to public health and animal food-production plays a crucial role in AMR spread. We thus aimed to characterize AMR profiles and associated factors in zoonotic bacterial isolates in Portugal. Data from the Portuguese AMR surveillance program on animal populations and derived food, 2014-2018, was used. AMR frequency was described in E coli, Campylobacter and Salmonella isolates from poultry and pigs, according to antibiotic and samples tested. For Salmonella, AMR associated factors were studied: animal populations (broilers, laying hens, pigs) and derived meat, sampling stage (farm, slaughterhouse, processing plant), sample type (environmental, carcase, food), sampler (HACCP, industry, official, official and industry), sample context (control and eradication programmes, monitoring), year (2014-2018) and season. Logistic regression was applied to estimate crude (OR) and adjusted odds ratio (aOR) with 95% confidence intervals (95%CI). The final model was obtained using a backward stepwise method. We assessed 2157 E Coli, 561 Campylobacter and 826 Salmonella isolates. AMR rates were higher to cefepime (91-98%) in E coli in all sample types; cefotaxime (100%) in E coli in broiler's meat; nalidixic acid (79-96%) in E coli and Campylobacter in poultry and derived meat; ciprofloxacin (50-98%) in all bacteria isolates from poultry and derived meat. For Salmonella, AMR was more likely in pig's meat (OR 3.66; 95%CI:1.19-2.82), slaughterhouses (OR 10.18; 95%CI:4.69-26.70), carcases (OR 5.90;95%CI:3.74-9.69). The final model indicated a lesser chance of AMR in laying hens (aOR .21; 95%CI:.11-.37), industry sampling (aOR .25; 95%CI:.07-.73), 2018 (aOR .24; 95%CI:.13-.42), and a higher chance in summer (aOR 2.39; 95%CI:1.34-4.28). The findings support the need for control measures on the use of key antibiotics in veterinary medicine. AMR occurrence in Portugal seems to be related to summer, although less in laying hens and in 2018. Key messages AMR in bacterial isolates suggests the need for integrated actions to mitigate and control the use of 3rd and 4rd generation cephalosporins, fluoroquinolones and quinolones in animal production. AMR occurrence in Portugal seems to be further related to summer conditions, while comparing to other seasons.


2020 ◽  
Vol 10 (03) ◽  
pp. 426-430
Author(s):  
Suhad Hadi Mohammed ◽  
Maysaa Saleh Mahdi ◽  
Mohanad Mohsin Ahmed ◽  
Ali Najm Al-Deen ◽  
Nargis Fadhil ◽  
...  

Determining the bacterial causative agents of infections by identifying their antimicrobial patterns will enable health institutions to limit the unnecessary use of antibiotics, and take active ways in preventing the spread of drug-resistant bacteria. This study aimed to identify the most common bacterial isolates responsible for infection and their antibiotic resistance rates. The results showed that Escherichia coli, Staphylococcus aureus (S aureus), and Pseudomonas aeruginosa (P. aeruginosa) represent the most common bacteria isolated with a percentage of 23.9, 18.8, and 16.2%, respectively. High resistance rates were found for the most common bacterial isolates. Other important findings are the presence of extended-spectrum B-lactamase (ESBL) producing bacteria and the appearance of hetero-resistance phenomenon. Moreover, the bacterial infection is mainly occurring in men. No significant correlation was observed in the type of isolated bacteria with patient admission status. E. coli strains were found to be highly resistant to amoxicillin-clavulanic acid, ceftriaxone (88.9%), ceftazidime (85.2%), trimethoprim-sulfamethoxazole (74.1%), and ciprofloxacin (59.3%). Whereas, the highest sensitivity rates were seen with meropenem antibiotic (92.6%). Concerning S. aureus isolates, 100, and approximately 91% of resistant rates were seen to penicillin and cefoxitin, respectively [methicillin-resistant S. aureus (MRSA)]. Approximately 50% of MRSA were vancomycin-resistant S. aureus (VRSA). Resistant rates of P. aeruginosa isolates to gentamycin and ciprofloxacin were 47.1%, amikacin 41.2%, and levofloxacin 35.3%. In conclusion, the current study might reveal that the isolated bacteria could be of critical priority carbapenem-resistant P. aeruginosa, and carbapenem-resistant and 3rd generation cephalosporin-resistant E. coli. In addition, the isolation of high priority bacteria includes vancomycin-resistant methicillin-resistant S. aureus.


2021 ◽  
Vol 22 (3) ◽  
pp. 397-406
Author(s):  
O.J. Akinjogunla ◽  
A.N. Umo ◽  
M.F. Alozie ◽  
G.O. Oshosanya ◽  
G.I. Saturday

Background: The emergence of multi-drug resistant bacterial strains worldwide has necessitated the scientific search for novel, potent, and affordable antimicrobial agents including medicinal plants and non-antibiotic drugs for therapy of infectious diseases. The objective of this study is to assess in vitro antibacterial activities and time kill kinetics of some non-antibiotic drugs against pathogenic clinical bacterial isolates.Methodology: In vitro antibacterial activities including minimum inhibitory concentration (MIC), minimum bactericidal concentration  (MBC) and time kill kinetics of Amlodipine (AML), Thioridazine (THI) and Promethazine (PRO) against Staphylococcus aureus, coagulase negative staphylococci (CoNS), Streptococcus spp, Escherichia coli, Enterobacter spp, Klebsiella pneumoniae and Pseudomonas aeruginosa clinical isolates were determined using disc diffusion, broth microdilution and plate count techniques.Results: The mean growth inhibition zones by the disc diffusion assay of AML, THI and PRO against the isolates were ≤15.1±1.0 mm with MIC and MBC values ranging from 12.5 to 50μg/ml and 25 to 100μg/ml respectively. The time-kill assay revealed bactericidal effect of AML, THI and PRO on Gram positive bacteria evidenced by mean log reductions in viable bacterial cell counts ranging from 0.13 Log10 to 2.41 Log10 CFU/ml for S. aureus, 0.88 Log10 to 2.08 Log10 CFU/ml for Streptococcus spp, and 0.26 Log10 to 2.34 Log10 CFU/ml for CoNS after ≤30hrs post inoculation at 1xMIC. The range of log reduction in viable cell counts of Gram-negative bacteria exposed to AML, THI and PRO were E. coli (0.11 to 3.23 Log10 CFU/ml), P. aeruginosa (0.52 to 2.56 Log10 CFU/ml), K. pneumoniae (0.85 to 3.0 Log10 CFU/ml) and  Enterobacter spp (0.38 to 2.08 Log10 CFU/ml) after ≤30 hrs post inoculation at 1x MIC.Conclusion: These findings demonstrate in vitro antibacterial efficacies and time kill kinetics of AML, THI and PRO against pathogenic clinical bacterial isolates, which indicate that these non-antibiotic drugs may be useful therapeutic alternatives in the bid to reduce the burden of infectious diseases associated with antibiotic resistant pathogens. Keywords: Amlodipine, Thioridazine, Promethazine, Time-Kill, Kinetics, MIC, MBC, bacteria   French title: Activité antibactérienne et cinétique de destruction du temps de l'amlodipine, de la thioridazine et de la prométhazine contre les isolats bactériens cliniques pathogènes Contexte: L'émergence de souches bactériennes multirésistantes dans le monde a rendu nécessaire la recherche scientifique d'agents antimicrobiens nouveaux, puissants et abordables, notamment des plantes médicinales et des médicaments non antibiotiques pour le traitement des maladies infectieuses. L'objectif de cette étude est d'évaluer les activités antibactériennes in vitro et la cinétique de destruction temporelle de certains médicaments non antibiotiques contre les isolats bactériens cliniques pathogènes. Méthodologie: activités antibactériennes in vitro, y compris la concentration minimale inhibitrice (CMI), la concentration bactéricide minimale (MBC) et la cinétique de destruction du temps de l'amlodipine (AML), de la thioridazine (THI) et de la prométhazine (PRO) contre Staphylococcus aureus, les staphylocoques à coagulase négative (CoNS), Streptococcus spp, Escherichia coli, Enterobacter spp, Klebsiella pneumoniae et Pseudomonas aeruginosa ont été déterminés en utilisant des techniques de diffusion sur disque, de microdilution en bouillon et de numération sur plaque. Résultats: Les zones moyennes d'inhibition de la croissance par le test de diffusion de disque d'AML, THI et PRO contre les isolats étaient ≤15,1±1,0mm avec des valeurs MIC et MBC allant de 12,5 à 50μg/ml et de 25 à 100μg/ml respectivement. Le dosage temporel a révélé un effet bactéricide de la LMA, du THI et du PRO sur les bactéries Gram positives, mis en évidence par des réductions logarithmiques moyennes du nombre de cellules bactériennes viables allant de 0,13 Log10 à 2,41 Log10 CFU/ml pour S. aureus, 0,88 Log10 à 2,08 Log10 CFU/ml pour Streptococcus spp et 0,26 Log10 à 2,34 Log10 CFU/ml pour CoNS après ≤ 30 heures après l'inoculation à 1 x MIC. La plage de réduction logarithmique du nombre de cellules viables de bactéries à Gram négatif exposées à la LMA, au THI et au PRO était E. coli (0,11 à 3,23 Log10 CFU/ml), P. aeruginosa (0,52 à 2,56 Log10 CFU/ml), K. pneumoniae (0,85 à 3,0 Log10 CFU/ml) et Enterobacter spp (0,38 à 2,08 Log10 CFU/ml) après ≤ 30 heures après l'inoculation à 1 x MIC. Conclusion: Ces résultats démontrent une efficacité antibactérienne in vitro et une cinétique de destruction du temps des LMA, THI et PRO contre les isolats bactériens cliniques pathogènes, ce qui indique que ces médicaments non antibiotiques peuvent être des alternatives thérapeutiques utiles dans le but de réduire le fardeau des maladies infectieuses associées aux antibiotiques pathogènes résistants. Mots-clés: Amlodipine, Thioridazine, Prométhazine, Time-Kill, Cinétique, MIC, MBC, bactéries  


2019 ◽  
Vol 22 (1) ◽  
pp. 49
Author(s):  
Gita Wismayanti ◽  
Sri Sedjati ◽  
Agus Trianto

Marine invertebrates are the most productive source of bioactive compounds.  However, most of the compounds originally produced by the microorganisms living associated with the invertebrates.  Barnacle is an invertebrate that has a unique interaction with bacteria. Escherichia coli and Bacillus cereus are the cause of the foodborne disease that causes of remarkedly losses in the food industry.  The barnacle was collected from Panjang Island, Jepara.  The bacterial isolates were obtained by serial dilution followed by isolation based on morphological characteristics.  The antagonistic assay to E. coli dan B. cereus was utilized for screened the isolates.  Then, the active isolates were cultured for the further test with the disc diffusion agar method of the supernatant followed by the extracts.  The most active isolates were identified based on molecular method.  A total of 14 isolates were obtained from the Balanus sp., which six of them have activity against the E. coli and B. cereus.  The isolates TJ 5.4 and TJ 5.5 have the strongest activity the bacteria.  Base on the analyses of the BLAST and phylogenetic tree the isolates showed 99% homology the Bacillus wiedmannii (TJ 5.4) and Lysinibacillus macroides (TJ 5.5). Invertebrata laut merupakan salah satu sumber bahan bioaktif yang paling produktif. Sebagian senyawa yang terdapat dalam biota laut, sejatinya diproduksi oleh mikroorganisme yang hidup berasosiasi dengan biota laut tersebut.  Teritip merupakan salah satu hewan invertebrata yang memiliki berbagai interaksi unik dengan bakteri. Bakteri Escherichia coli dan Bacillus cereus merupakan dua dari beberapa bakteri patogen yang sering menjadi agen penyebab foodborne disease.  Teritip dikoleksi dari Pulau Panjang, Jepara. Isolat bakteri diperoleh dengan metoda pengenceran bertingkat dan dilanjutkan isolasi berdasarkan karakteristik morfologis. Uji antagonis terhadap E. coli dan B. cereus digunakan untuk menskrining bioaktivitas isolat.  Isolat yang aktif dikultur untuk uji lanjut yaitu supernatant dan dilanjutkan ekstraknya dengan metoda disc diffusion agar.  Bakteri yang paling aktif diidentifikasi secara molekuler untuk mengetahui spesiesnya.  Sebanyak 14 isolat bakteri diperoleh dari Balanus sp. dimana enam diantaranya memiliki aktivitas terhadap bakteri uji.  Isolat TJ 5.4 dan TJ 5.5 memiliki aktivitas paling kuat terhadap E. coli dan B. cereus. Berdasarkan pengolahan sekuen dan analisis pohon filogenetik, dua isolat bakteri tersebut memiliki homologi 99% terhadap bakteri Bacillus wiedmannii (TJ 5.4) dan Lysinibacillus macroides (TJ 5.5). 


2017 ◽  
Vol 11 (1) ◽  
pp. 23-30 ◽  
Author(s):  
Pooja Shakya ◽  
Dhiraj Shrestha ◽  
Elina Maharjan ◽  
Vijay K. Sharma ◽  
Rabin Paudyal

Introduction:Increase in extended-spectrum β-lactamases (ESBL) producing microbes in recent years has led to limitations of treatment options. This study aimed to assess the prevalence of ESBL producingE. coliandKlebsiellaspp. at a tertiary hospital in Nepal.Methods:A total of 2209 non-repetitive mid-stream urine (MSU) samples were collected during the study period (March to September 2014). Identification of the isolates was done by Gram's staining followed by biochemical tests. Antibiotic susceptibility testing was done by modified Kirby-Bauer disc diffusion method and interpretation was done following Clinical and Laboratory Standard Institute (CLSI) guidelines, 2013. ESBL screening amongE. coliandKlebsiellaspp. isolates were done using ceftriaxone, cefotaxime, ceftazidime and cefpodoxime. The confirmation was done by phenotypic disc diffusion test (combined disc method) using ceftazidime (30µg) and ceftazidime plus clavulanic acid (30/10µg), and cefotaxime (30µg) and cefotaxime plus clavulanic acid (30/10µg) disc as per CLSI guidelines.Results:A total of 451 samples showed significant bacteriuria with 365 (80.9%)E. coli, 17 (3.8%)Klebsiella pneumoniaeand 3 (0.7%)Klebsiella oxytoca. Of 451 isolates, 236 (52.3%) were found MDR strains. By combined disk test, 33 (91.7%)E. coliand 3 (8.3%)Klebsiellaspp. were found ESBL producers.Conclusion:Higher prevalence of ESBL producingE. coliandKlebsiellaspp. was observed warranting prompt need of surveillance for effective management of such MDR strains.


2020 ◽  
Author(s):  
Rosine Manishimwe ◽  
Paola M. Moncada ◽  
Marie Bugarel ◽  
H. Morgan Scott ◽  
Guy H. Loneragan

AbstractThis study was conducted to develop and field-test a low cost protocol to estimate the isolate- and sample-level prevalence of resistance to critically important antibiotic drugs among Escherichia coli and Salmonella isolated from dairy cattle feces. E. coli and Salmonella were isolated from and screened on selective media, with and without antibiotics respectively. Bacterial isolates were further tested for susceptibility to a suite of antibiotics using disk diffusion. Molecular methods were performed on select bacterial isolates to identify and distinguish genetic determinants associated with the observed phenotypes. Among 85 non-type-specific E. coli randomly isolated from MacConkey agar without antibiotics, the isolate-level prevalence of resistance to tetracycline was the highest (8.2%), there was no isolate resistant to third-generation cephalosporin (0.0%) and one isolate was resistant to nalidixic acid (1.2%). Among 37 E. coli recovered from MacConkey agar with cefotaxime at 1.0µg/ml, 100% were resistant to ampicillin and 56.8% were resistant to a third-generation cephalosporin (ceftriaxone). Among 22 E. coli isolates recovered from MacConkey agar with ciprofloxacin at 0.5µg/ml, 90.9% were resistant to tetracycline whereas 77.3% and 54.5% were resistant to nalidixic acid and ciprofloxacin respectively. Sixteen Salmonella were isolated and only one demonstrated any resistance (i.e., single resistance to streptomycin). Among E. coli isolates that were either resistant or intermediate to ceftriaxone, an AmpC phenotype was more common than an extended spectrum beta-lactamase (ESBL) phenotype (29 versus 10 isolates, respectively). Among 24 E. coli isolates that were whole genome sequenced, phenotypic profiles of antibiotic resistance detected were generally substantiated by genotypic profiles. For instance, all isolates with an AmpC phenotype carried a blaCMY2 gene. The protocol used in this study is suited to detecting and estimating prevalence of antimicrobial resistance in bacteria isolated from food animal feces in resource-limited laboratories in the developing world.


2019 ◽  
Vol 22 (1) ◽  
pp. 49
Author(s):  
Gita Wismayanti ◽  
Sri Sedjati ◽  
Agus Trianto

Marine invertebrates are the most productive source of bioactive compounds.  However, most of the compounds originally produced by the microorganisms living associated with the invertebrates.  Barnacle is an invertebrate that has a unique interaction with bacteria. Escherichia coli and Bacillus cereus are the cause of the foodborne disease that causes of remarkedly losses in the food industry.  The barnacle was collected from Panjang Island, Jepara.  The bacterial isolates were obtained by serial dilution followed by isolation based on morphological characteristics.  The antagonistic assay to E. coli dan B. cereus was utilized for screened the isolates.  Then, the active isolates were cultured for the further test with the disc diffusion agar method of the supernatant followed by the extracts.  The most active isolates were identified based on molecular method.  A total of 14 isolates were obtained from the Balanus sp., which six of them have activity against the E. coli and B. cereus.  The isolates TJ 5.4 and TJ 5.5 have the strongest activity the bacteria.  Base on the analyses of the BLAST and phylogenetic tree the isolates showed 99% homology the Bacillus wiedmannii (TJ 5.4) and Lysinibacillus macroides (TJ 5.5). Invertebrata laut merupakan salah satu sumber bahan bioaktif yang paling produktif. Sebagian senyawa yang terdapat dalam biota laut, sejatinya diproduksi oleh mikroorganisme yang hidup berasosiasi dengan biota laut tersebut.  Teritip merupakan salah satu hewan invertebrata yang memiliki berbagai interaksi unik dengan bakteri. Bakteri Escherichia coli dan Bacillus cereus merupakan dua dari beberapa bakteri patogen yang sering menjadi agen penyebab foodborne disease.  Teritip dikoleksi dari Pulau Panjang, Jepara. Isolat bakteri diperoleh dengan metoda pengenceran bertingkat dan dilanjutkan isolasi berdasarkan karakteristik morfologis. Uji antagonis terhadap E. coli dan B. cereus digunakan untuk menskrining bioaktivitas isolat.  Isolat yang aktif dikultur untuk uji lanjut yaitu supernatant dan dilanjutkan ekstraknya dengan metoda disc diffusion agar.  Bakteri yang paling aktif diidentifikasi secara molekuler untuk mengetahui spesiesnya.  Sebanyak 14 isolat bakteri diperoleh dari Balanus sp. dimana enam diantaranya memiliki aktivitas terhadap bakteri uji.  Isolat TJ 5.4 dan TJ 5.5 memiliki aktivitas paling kuat terhadap E. coli dan B. cereus. Berdasarkan pengolahan sekuen dan analisis pohon filogenetik, dua isolat bakteri tersebut memiliki homologi 99% terhadap bakteri Bacillus wiedmannii (TJ 5.4) dan Lysinibacillus macroides (TJ 5.5). 


2019 ◽  
Vol 70 (5) ◽  
pp. 1778-1783
Author(s):  
Andreea-Loredana Golli ◽  
Floarea Mimi Nitu ◽  
Maria Balasoiu ◽  
Marina Alina Lungu ◽  
Cristiana Cerasella Dragomirescu ◽  
...  

To determine the resistance pattern of bacterial pathogens involved in infections of the patients aged between 18-64 years, admitted in a ICU from a 1518-bed university-affiliated hospital. A retrospective study of bacterial pathogens was carried out on 351 patients aged between 18-64 years admitted to the ICU, from January to December 2017. In this study there were analysed 469 samples from 351 patients (18-64 years). A total of 566 bacterial isolates were obtained, of which 120 strains of Klebsiella spp. (35.39%%), followed by Nonfermenting Gram negative bacilli, other than Pseudomonas and Acinetobacter (NFB) (75- 22.12%), Acinetobacter spp. (53 - 15.63%), Pseudomonas aeruginosa and Proteus (51 - 15.04%), and Escherichia coli (49 - 14.45%). The most common isolates were from respiratory tract (394 isolates � 69.61%). High rates of MDR were found for Pseudomonas aeruginosa (64.70%), MRSA (62.65%) and Klebsiella spp. (53.33%), while almost all of the isolated NFB strains were MDR (97.33%). There was statistic difference between the drug resistance rate of Klebsiella and E. coli strains to ceftazidime and ceftriaxone (p[0.001), cefuroxime (p[0.01) and to cefepime (p[0.01). The study revealed an alarming pattern of antibiotic resistance in the majority of ICU isolates.


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