Nonfermenting Gram-Negative Bacilli Infections in a Tertiary Care Hospital in Kolar, Karnataka

ABSTRACT AIM: Nonfermenting gram-negative bacilli (NFGNB), which are saprophytic in nature, have emerged as important healthcare-associated pathogens. They exhibit resistance not only to beta lactam and the other groups of antibiotics, but also to carbapenems. This study was undertaken to identify the nonfermenters isolated from various clinical samples, to assess their clinical significance, to know the type of healthcare-associated infections they caused, and to know their anti-microbial sensitivity pattern. Materials and Methods: The nonfermenters were identified using a standard protocol that included tests for motility, oxidase production, oxidation-fermentation test for various sugars, gelatin liquefaction, and growth on 10% lactose agar. The clinical significance was assessed by using various criteria and susceptibility testing was performed with the help of the Kirby-Bauer disc diffusion method. Results: A total of 193 NFGNB were isolated from 189 clinical specimens. Pseudomonas aeruginosa was the most common nonfermenter, accounting for 53.8%, followed by Acinetobacter baumannii (22.2%), and Pseudomonas fluorescens (10.8%). Other significant NFGNB isolated were: Sphingobacterium species (5.2%), Acinetobacter lwoffii (3.1%), and Stenotrophomonas maltophilia (2.6%). P. aeruginosa showed good sensitivity to imipenem (94%), cefoperazone (70%), amikacin (69%), and ticarcillin (63%). A. baumannii showed 100% sensitivity to imipenem and 70% sensitivity to piperacillin. Conclusion: P. aeruginosa and A. baumannii were the common NFGNB isolated in our study from patients of, urinary tract infection, bacteremia, surgical site infections, and ventilator associated pneumonia. P. aeruginosa showed good sensitivity to imipenem, amikacin, and cefoperazone while A. baumannii showed good sensitivity to imipenem and piperacillin.

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TO STUDY ANTIBIOTIC SENSITIVITY PATTERN OF NONFERMENTATIVE GRAM NEGATIVE BACILLI FROM VARIOUS CLINICAL SAMPLES IN A TERTIARY CARE HOSPITAL, JAIPUR.

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i5.1132 ◽

2020 ◽

Vol 4 (5) ◽

Author(s):

Kirti Hemwani ◽

P. S. Nirwan ◽

Preeti Shrivastava ◽

Abhiraj Ramchandani

Keyword(s):

Tertiary Care ◽

Antibiotic Sensitivity ◽

Polymyxin B ◽

Hospital Environment ◽

Diffusion Method ◽

Clinical Samples ◽

Care Hospital ◽

Pathogenic Potential ◽

Gram Negative ◽

Sensitivity Pattern

Background: Nonfermentative gram negative bacilli (NFGNB) frequently considered as commensals or contaminants but the pathogenic potential of nonfermenters has been proved beyond doubt. They are resistant to commonly used antimicrobials. Aim: This study was undertaken to identify the nonfermenters isolated from various clinical samples and to know their Antibiotic sensitivity pattern. Materials and Methods: The present study was carried out on 150 strains of Nonfermenters isolated from 1200 various non repetitive clinical samples received in Department of Microbiology, NIMS Jaipur. Nonfermenters were identified using a standard protocol and their antibiotic susceptibility testing was performed with the help of the modified Bauer disc diffusion method. Results: Out of 150 nonfermenters isolated, Pseudomonas aeruginosa was the most common isolate 134 (89.33%) followed by Acinetobacter baumannii 16 (10.67%). Among all clinical samples Pus and Wound Discharge yield maximum isolates of NFGNB i.e. 54 (36%) % followed by sputum (39.0%). Most sensitive drug against NFGNB was Polymyxin-B (100%) followed by Imipenem (86 %) and Amikacin (71.33 %). Conclusion: Nonfermenters have a great potential to survive in a hospital environment so implementation of antibiotic stewardship programs and strict infection control practices will be required to prevent or slow down their emergence and spread. Keywords: Nonfermenters, Polymyxin-B, Pseudomonas, Acinetobacter.

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Antimicrobial Sensitivity Pattern in the Mixed Intensive Care Unit in a Tertiary Care Hospital of Eastern Nepal

Eastern Green Neurosurgery ◽

10.3126/egn.v2i2.29237 ◽

2020 ◽

Vol 2 (2) ◽

pp. 9-15

Author(s):

Niraj Kumar Keyal ◽

Mahendra Shrestha ◽

Partima Sigdel Ghimire

Keyword(s):

Intensive Care Unit ◽

Staphylococcus Aureus ◽

Intensive Care ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Polymyxin B ◽

Clinical Samples ◽

Care Hospital ◽

Gram Negative ◽

Sensitivity Pattern

Background: Empirical antibiotics are used in the intensive care unit based on developing countries’ guidelines due to a lack of a bacteriological profile of individual ICU and institution policy. Therefore, this study was conducted to know the antibiogram of the intensive care unit and to make institution policy for antibiotic use in ICU. Materials and methods: It was a prospective descriptive cross-sectional study conducted in the mixed surgical and medical intensive care unit of a tertiary care hospital for one year in 625 patients. Various clinical samples were collected aseptically and organisms were identified by the cultural characteristics, morphology, gram stain, and different biochemical test. Antimicrobial susceptibility was done with a disc diffusion test. Data collection was done in a preformed sheet that included all tested antibiotic and demographic variables. Statistical analysis was done by using statistical package for the social sciences. The result was presented as frequency and percentage. Results: Out of 625 samples, 135(22%) showed growth in culture. Among them, 96(71%) and 39(29%) were gram-negative bacilli and gram-positive cocci respectively. The tracheal aspirate was the most common type of specimen which comprised 49(36.29%) isolates. The most common organism was Staphylococcus aureus which accounts for 27(20%) isolates, followed by Acinetobacter baumanni 25(18.51%), Klebsiella pneumoniae 22(16.29%) and Pseudomonas aeurignosa 21(15.55%). The incidence of multidrug-resistant and extended drug resistance was 44(32.5%) and 45(33%) respectively. Meanwhile, the incidence of methicillin-resistant staphylococcus aureus was 70%. However, in the case of Acinetobacter baumannii and Enterobacteriaceae, all were sensitive to polymyxin B and meropenem. Conclusion:Antibiotics should be prescribed based on the antibiogram of individual intensive care units that can decrease antibiotic resistance. Polymyxin B and meropenem can be prescribed for gram-negative bacilli and vancomycin for Staphylococcus aureus.

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Prevalence of MDR and ESBL producing Gram-negative isolates from various clinical samples from patients visiting a tertiary care hospital in Kathmandu, Nepal

10.21203/rs.3.rs-198444/v1 ◽

2021 ◽

Author(s):

Aryatara Shilpakar ◽

Mehraj Ansari ◽

Kul Raj Rai ◽

Ganesh Rai ◽

Shiba Kumar Rai

Keyword(s):

Tertiary Care Hospital ◽

Tertiary Care ◽

Polymyxin B ◽

Confirmatory Test ◽

Diffusion Method ◽

Clinical Samples ◽

Care Hospital ◽

Severe Problem ◽

Gram Negative ◽

Esbl Producers

Abstract BackgroundThe existence of multi-drug resistance organisms, including extended-spectrum beta-lactamases (ESBLs), is on the rise and is becoming a severe problem. Knowledge of the prevalence and antibiogram profile of such isolates is essential to develop an appropriate treatment methodology. This study aimed to study the prevalence of Gram-negative isolates exhibiting ESBL at a tertiary care hospital and study their antibiogram profile.MethodsA cross-sectional study was conducted at Shahid Gangalal National Heart Centre, Kathmandu, Nepal, from June 2018 to November 2018. A total of 770 clinical samples were collected and identified by using the conventional biochemical tests following the Clinical and Laboratory Standard Institute (CLSI) guidelines. Antimicrobial susceptibility testing (AST) was performed using the Kirby Bauer disc diffusion method. The screening test for ESBL producers was performed as recommended by the CLSI and the confirmatory test was performed phenotypically using the E-test.ResultsOut of 92 isolates, 84 (91.3%) isolates were multidrug resistant, and 47 (51.1%) isolates were found to be potential ESBL producers. Of these, 16 isolates were confirmed ESBL producers by the E-test. Escherichia coli and Klebsiella pneumoniae were the predominant isolates and were also the major ESBL producers. Besides polymyxin B (100% sensitive), meropenem and imipenem showed high efficacy against the ESBL producers.ConclusionMultidrug resistance was very high, however, ESBL production was low. Polymyxin B and carbapenems are the choice of drugs against ESBL producers but should be used only as the last line drugs.

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Prevalence of nonfermentative gram-negative bacilli and their antimicrobial susceptibility profiles in a tertiary care hospital of Eastern India

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20181070 ◽

2018 ◽

Vol 5 (2) ◽

pp. 366 ◽

Cited By ~ 2

Author(s):

Mandira Sarkar ◽

Jagadananda Jena ◽

Dipti Pattnaik ◽

Bandana Mallick

Keyword(s):

Antimicrobial Susceptibility ◽

Nosocomial Infections ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Burkholderia Cepacia Complex ◽

Diffusion Method ◽

Clinical Samples ◽

Care Hospital ◽

Isolation And Identification ◽

Gram Negative

Background: Nonfermentative gram-negative bacilli (nonfermenters) have emerged as a major concern for nosocomial infections. They exhibit resistance not only to the beta-lactam and other group of antibiotics but also to carbapenems. This study was undertaken to know the prevalence of nonfermenters from clinical samples along with their antimicrobial susceptibility profile.Methods: A cross-sectional study over a period of 21 months in the microbiology laboratory of a tertiary care hospital was done. Clinical samples were processed by conventional bacteriological methods for isolation and identification. Susceptibility testing was done by Kirby-Bauer disc diffusion method as recommended by Clinical and Laboratory Standard Institute.Results: 411 nonfermenters (13.18%) were isolated from 3116 culture positive clinical samples. Out of these nonfermenters, most were Acinetobacter baumannii (51.34%) followed by Pseudomonas aeruginosa (42.09%), Burkholderia cepacia complex (4.38%) and others (2.19%). Others included Burkholderia pseudomellei, Acinetobacter lwoffii and Stenotrophomonas maltophilia. Highest sensitivity to gentamicin and amikacin were shown by A. baumannii and P. aeruginosa respectively while both were mostly resistant to ceftriaxone. Burkholderia and Stenotrophomonas species showed 100% sensitivity to cotrimoxazole. A. baumannii was the most prevalent nonfermenter in intensive care units.Conclusions: Timely identification of nonfermenters and monitoring their susceptibility patterns will help in proper management of infections caused by them. Improved antibiotic stewardship and infection control measures should be implemented to prevent nosocomial infections and spread of drug resistant nonfermenters.

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Frequency and susceptibility pattern of metallo-beta-lactamase producers in a hospital in Pakistan

The Journal of Infection in Developing Countries ◽

10.3855/jidc.1050 ◽

2010 ◽

Vol 4 (12) ◽

pp. 810-813 ◽

Cited By ~ 11

Author(s):

Fatima Kaleem ◽

Javaid Usman ◽

Afreenish Hassan ◽

Aslam Khan

Keyword(s):

Tertiary Care ◽

Diffusion Method ◽

Clinical Samples ◽

Care Hospital ◽

Gram Negative ◽

Medical College ◽

Strip Method ◽

Carbapenem Resistant ◽

Microbiological Methods ◽

National University

Introduction: The rapid spread of acquired metallo-beta-lactamases (MBLs) among major Gram-negative pathogens is an emerging threat and a matter of particular concern worldwide. Methodology: This descriptive study was conducted between January and August 2009 in the department of Microbiology, Army Medical College, National University of Sciences and Technology, Rawalpindi, to determine the frequency and susceptibility patterns of MBL-producers among carbapenem-resistant Gram-negative rods (GNRs) from clinical isolates of a tertiary care hospital. All clinical samples were processed according to standard microbiological methods. Isolated GNRs were subjected to susceptibility testing against various antibiotics by disc diffusion method according to the Clinical and Laboratory Standards Institute (CLSI) guidelines. Carbapenem-resistant isolates were subjected to the detection of MBL production by the E-test MBL strip method. Results: Out of 50 carbapenem resistant isolates, 39 (78%) of were confirmed to be MBL producers by the E-strip method. Acinetobacter baumannii were the most frequent MBL producers, followed by Pseudomonas aeruginosa. A total of 19 (37%) of the MBL producers were susceptible to cefoperazone-sulbactam. Conclusion: The findings strongly suggest that there is a need to track the detection of MBL producers and that judicious use of carbapenems is necessary to prevent the further spread of these organisms.

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Prevalence of extended-spectrum beta-lactamase producing gram negative isolates in Enterobacteriaceae group of bacteria in clinical samples from a tertiary care hospital

10.17727/jmsr.2021/9-23 ◽

2021 ◽

Vol 9 (3) ◽

pp. 162-168

Author(s):

Parmar M ◽

Halpati A ◽

Desai K

Keyword(s):

General Hospital ◽

Antibiotic Susceptibility ◽

Tertiary Care ◽

Diffusion Method ◽

Clinical Samples ◽

Care Hospital ◽

Microbiology Laboratory ◽

Gram Negative ◽

Extended Spectrum ◽

Antibiotic Susceptibility Test

Introduction: Extended spectrum β-lactamases (ESBLs) are enzymes that intervene resistance to extended-spectrum (third generation) cephalosporins (e.g., ceftazidime, cefotaxime, and ceftriaxone) and but do not affect carbapenems (e.g., meropenem or imipenem). Though the number of ESBLs producing organism has been increasing day by day, the detection methods and treatment option for them are extremely limited. Objective: Objective of the study was to investigate the rate of ESBLs production and their antibiotic susceptibility pattern. Materials and method: A total 200 Gram negative isolates from various clinical samples received in microbiology laboratory, Sir Takhtsinhji General Hospital, Bhavnagar were studied and Antibiotic susceptibility test was done for commonly used antibiotics. A hospital-based study was conducted in microbiology laboratory, Sir Takhtsinhji General Hospital, Bhavnagar from February 2012 to August 2012. A total of 200 Gram negative isolates from various clinical samples were collected and identified using the conventional biochemical tests following the Clinical and Laboratory Standard Institute (CLSI) guidelines. Antimicrobial susceptibility testing (AST) was performed using the standardized Kirby-Bauer disk diffusion method. Results: Among the total isolates 89(44.5%) were ESBLs producer, and the rate of ESBLs positivity was 39.8% for E. coli (33 out of 83), 10% for Proteus mirabilis (1 out of 10), 51.4% for Klebsiella spp (55 out of 107). ESBLs producing organisms were resistant to most of the antibiotics but 100% were sensitive to imipenem, meropenem, and cefoperazone + sulbactam. Conclusion: Screening for ESBLs production requires to be carried out regularly in all clinical diagnostic laboratories to direct clinicians in appropriate selection of antibiotics.

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Pseudomonas aeruginosa Infection and Antibiotic Sensitivity Pattern Isolated from a Tertiary Care Hospital in Dhaka City

Asian Journal of Research in Infectious Diseases ◽

10.9734/ajrid/2021/v8i230233 ◽

2021 ◽

pp. 23-29

Author(s):

Mousumi Karmaker ◽

Md. Abul Khair ◽

Una Jessica Sarker ◽

Rabeya Nahar Ferdous ◽

Sa’dia Tasnim ◽

...

Keyword(s):

Pseudomonas Aeruginosa ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Health Sciences ◽

Diffusion Method ◽

Clinical Samples ◽

Resistance Pattern ◽

Resistant Bacteria ◽

Care Hospital ◽

Sensitivity Pattern

Pseudomonas aeruginosa is one of the most widespread gram-negative microorganisms identified in the clinical samples and most common causes of hospital acquired infection. P. aeruginosa is affecting both indoor and outdoor patients throughout the world. Due to frequent mutation in P. aeruginosa highly resistant strain developed rapidly. The aim of the study to determine the prevalence of P. aeruginosa species in different samples isolated from a Tertiary care Hospital as well as determination their diverse antibiotic resistance pattern. This cross-sectional study was carried out to determine in-vitro resistance pattern of P. aeruginosa isolates to common antimicrobial agents by disc diffusion method. Various clinical samples were collected from Bangladesh Health Sciences Hospital (BIHS) General Hospital, Dhaka. This research was carried out in the Department of Microbiology of Bangladesh University of Health Sciences (BUHS). Isolation, identification and antibiogram were performed for P. aeruginosa following standard microbiological laboratory procedure. A total of 218 P. aeruginosa were isolated from 3062 different clinical specimens which are statistically significant (p<0.0001). Among the highest number of P. aeruginosa were isolated from outdoor patients 140 compare to Indoor patients which are significantly higher (p <0.013). In this study Male (68.3%) are more vulnerable to P. aeruginosa infection compare to females (31.7%) which is also statistically significant. Young people (less than 35 years) were more susceptible to P. aeruginosa infection which is also statistically significant (p< 0.01). The highest number of P. aeruginosa was isolated from wound (43.12%), followed by pus (40.33%), sputum (8.71%) urine (7.80%). The maximum number of P. aeruginosa in various samples was resistant to aztreonam and co-tromoxazole followed by cephalosporins, aminoglycosides, carbapenems. The most sensitive antibiotic was colistin of followed by gentamycin and tetracycline. To control the spread of resistant bacteria, it is disparagingly vital to have stringent antibiotic guidelines. The antibiotic susceptibility pattern of P. aeruginosa requires to be continuously monitored in specialized clinical units and the results readily made available to the clinicians to minimize the resistance.

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Prevalence of imipenem resistant gram-negative bacteria in a tertiary care hospital of Dhaka, Bangladesh

Bangladesh Journal of Medical Science ◽

10.3329/bjms.v21i1.56341 ◽

2022 ◽

Vol 21 (1) ◽

pp. 145-150

Author(s):

Rabeya Nahar Ferdous ◽

Md Atikur Rahman ◽

Md Anowar Hussain ◽

Nasrin Akhter ◽

Palash Chandra Banik ◽

...

Keyword(s):

Statistical Analysis ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Clinical Isolates ◽

Health Concern ◽

Diffusion Method ◽

Clinical Samples ◽

Gram Negative Bacteria ◽

Care Hospital ◽

Gram Negative

Objective: Imipenem resistant gram-negative bacteria (GNB) have become a major public health concern worldwide, including Bangladesh. The present study was performed to determine the frequency of imipenem resistant gram-negative bacteria (GNB), their antimicrobial susceptibility pattern. Materials and Methods: A total of three hundred and fifty clinical samples were collected from Bangladesh Institute of Health Sciences hospital (BIHS), Dhaka, Bangladesh, over a period of 12 months. Among 350 samples, 171 (48.86%) were from indoor patients, and 179 (51.14%) were from outdoor patients. The pathogens were isolated and identified by conventional methods and were screened for antibiotic susceptibility using the Kirby–Bauer disc diffusion method, including imipenem discs. A Chi-square test was employed for statistical analysis. Results and Discussion: Out of 350 clinical isolates, 246 showed resistance to imipenem (70.28%). Almost all of the imipenem resistant gram-negative bacteria showed the highest resistant pattern to cefepime (88.57%), amoxicillin (88.29%), cephalosporin (88.14%), cefoxitin (86%), tetracycline (84.42%), and the majority were resistant to levofloxacin (70.85%), doxycycline (70.57%), netilmicin (59.71%). But cotrimoxazole (13.42%) and tigecycline (11.43%) showed a lower resistance pattern. Statistical analysis exhibited imipenem resistant gram-negative isolates most commonly found in pus and urine samples, while Klebsiella spp (30.49%), Pseudomonas spp (26.83%) and E. coli (23.17%) were the most predominant pathogens. Conclusion: This is a retrospective study which study indicates a noteworthy rate of clinical isolates were imipenem resistant gram-negative bacteria in a well-defined tertiary care hospital, and most of these bacteria were also multidrug-resistant. Bangladesh Journal of Medical Science Vol. 21(1) 2022 Page : 145-150

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Clinical relevance, Speciation, and Antibiogram of Non -Diphtherial Corynebacteria isolated from various clinical samples in a tertiary care hospital in Zagazig, Egypt

10.51429/ejmm30207 ◽

2021 ◽

Vol 30 (2) ◽

pp. 43-49

Author(s):

Shymaa Yahia ◽

May M. Sami

Keyword(s):

Tertiary Care ◽

Resistance Rate ◽

University Hospital ◽

British Society ◽

Diffusion Method ◽

Clinical Samples ◽

Care Hospital ◽

Beta Lactam ◽

Beta Lactam Antibiotics ◽

Isolated Species

Background: The non-diphtherial Corynebacteria, also called “Coryneforms” bacteria are a diversified group of gram positive non sporing bacilli belonging to the genus Corynebacteria. Such bacteria are considered members of human microbiota (skin, respiratory and genital mucus membranes). Coryneform bacteria's pathogenic capacity has been undervalued until recently. Despite of frequently deemed as contaminants, these bacteria have been correlated to diverse clinical infections recently. Objectives: To isolate, speciate, and determine antimicrobial susceptibility pattern of clinically relevant non-diphtherial Corynebacteria from various clinical samples. Methodology: Different clinical samples (blood, urine, sputum, wound swabs, pus) collected from hospitalized patients attending at Zagazig University Hospital. The samples were processed and cultured as per conventional bacteriological methods. A total of 75 clinically relevant corynebacterial isolates exhibited speciation utilizing matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) analysis and their antibiogram was done by disc diffusion method by means of combined guidelines of Clinical and Laboratory Standards Institute (CLSI) as well as British Society for Antimicrobial Chemotherapy (BSAC) because of lack of definite CLSI guidelines. Results: The mean age of the studied patients was 64.6 ± 14.9 years, 60% were male and 40% female. A total 75 clinically relevant Corynebacteria species were obtained from different clinical samples, including wound swabs and pus (53%), sputum (20%), and blood (17%). Forty two percent were isolated from ICUs. The most prevalent isolated species was C.amycolatum (27%), C. striatum (20%), and C.jeikieum (16%). Beta lactam antibiotics showed least activity against Corynebacteria species with resistance rate against penicillin 76% and ceftriaxone 72%, while all isolates exhibited uniform sensitivity (100%) against vancomycin as well as linezolid. Conclusion: This study showed isolation of different clinically relevant non-diaphterial Corynebacteria from different clinical samples with pus and wound swabs as the most common samples from which Corynebacteria were isolated. In particular, C.amycolatum was the most common isolated species. Beta lactam antibiotics (penicillin, ceftriaxone) showed the least activity while vancomycin and linezolid were the most active agents against nondiapdhterial Corynebacteria isolates. Herein, we confirm diphtheroids’ clinical importance among different infections that necessitate evaluating their susceptibility patterns to some common antibacterial agents for guide the best antibiotic to treat infections caused by these species.

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Detection and genetic characterization of extended-spectrum beta-lactamases producers in a tertiary care hospital

Journal of Laboratory Physicians ◽

10.4103/jlp.jlp_31_19 ◽

2019 ◽

Vol 11 (03) ◽

pp. 253-258 ◽

Cited By ~ 1

Author(s):

Suryarashmi Sahoo ◽

Sarita Otta ◽

Bichitrananda Swain ◽

Subrat Kumar Kar

Keyword(s):

Klebsiella Oxytoca ◽

Tertiary Care ◽

Conventional Polymerase Chain Reaction ◽

Diffusion Method ◽

Care Hospital ◽

Beta Lactam ◽

Gram Negative ◽

Extended Spectrum Beta Lactamase ◽

Extended Spectrum ◽

Esbl Producers

Abstract BACKGROUND: Extended-spectrum beta-lactamase (ESBL)-producing organisms inactivate extended beta-lactam antibiotics and monobactams and also exhibit coresistance to many other classes of antibiotics. The present study was carried out to assess the prevalence of the ESBLs and to determine the most prevalent genotype in our hospital. MATERIALS AND METHODS: All clinically significant Gram-negative isolates were identified, and their antimicrobial susceptibility testing was done by Kirby–Bauers' disc diffusion method. ESBL detection was confirmed by minimal inhibitory concentration method using agar dilution technique for those who screened positive by ceftazidime (30 μg) disc. Further, the established ESBL-positive isolates were subjected to genotyping for bla TEM, bla CTX-M, and bla SHV genes by using conventional polymerase chain reaction. RESULTS: Escherichia coli was the most common (28.84%) Gram-negative bacillus followed by Klebsiella pneumoniae (18.07%), while Pseudomonas spp. (9.61%) was the most commonly identified nonfermenter. ESBL production was detected in 160 (30.8%) isolates. Klebsiella oxytoca (46.7%) followed by E. coli (44%) were the common ESBL producers. Most predominant ESBL gene was bla TEM, found in 122 (76.25%) isolates. Combinations of two genes were seen in 109 (68.1%) isolates, the most common (43.12%) combination being blaTEM and blaCTX-M. In this study, 16 (10%) strains had all the three types of genes. Most of the isolated Gram-negative bacilli (GNB) were sensitive to amikacin, imipenem, and colistin. CONCLUSION: In our study, the 30.8% of GNB were ESBL producers. This is the only study that shows that TEM is the most prevalent ESBL genotypes in our area. Of concern is a good number of isolates showing all three patterns of genes (TEM, SHV, and CTX-M). Amikacin, imipenem, and colistin were the most useful antibiotics in our setup.

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