Antimicrobial Resistance of Gram-Negative Bacteria Isolated from Lower Respiratory Tract Specimens of Hospitalized Patients

By mistake the wrong PDF was loaded for this article. The correct PDF was loaded on 19th September 2016. OBJECTIVES This study was designed with the objectives of describing the distribution pattern of microorganisms responsible for causing LRTI in the workers of garment industries.MATERIALS AND METHODS A total of 198 cases of suspected person of Lower Respiratory Tract infection (LRTI) LRTI were included in this study. This study was conducted between November 2009 to April 2010. Specimen for the study was expectorated sputum. Gram-stain, Ziehl-Neelsen stains and culture were performed.RESULTS On direct microscopic examination, 20.51% were Gram positive bacteria, 79.48% were Gram negative bacteria and 4% were smear positive AFB. On culture sensitivity examination, 22% percent showed growth of different bacteria in different culture media. The bacteria isolated from the samples included Klebsiella pneumoniae (15.38%), Proteus mirabilis (15.38%) and Citrobacterfruendii (15.38%). Gram Negative bacteria were found most susceptible to Ciprofloxacin (92.30%, 24/26) and Amikacin (92.30%, 24/26). Similarly, Gram Positive bacteria were found most susceptible to Ciprofloxacin (100%, 8/8) followed by Cloxacillin and Cephalexin (87.5%, 7/8). Smear positive AFB was significantly associated with not using the protective measures (mask) by workers and presence of symptoms (cough for more than two weeks, night sweat, hemoptysis and anorexia) (p=0.031). Culture positivity was significantly associated with symptoms like production of purulent sputum (p=0.045).CONCLUSION There was insignificant association between LRTI and risk factors present in working room of garment industries. Most of the isolates were sensitive to Ciprofloxacin and resistance to Ampicillin and Cephalexin.Journal of College of Medical Sciences-Nepal, 2014, Vol-10, No-3, 14-22

Download Full-text

Antimicrobial Susceptibility Pattern of Gram-Negative Bacteria Causing Lower Respiratory Tract Infections in Kathmandu University Hospital

Journal of Nepal Health Research Council ◽

10.33314/jnhrc.v18i4.2566 ◽

2021 ◽

Vol 18 (4) ◽

pp. 661-666

Author(s):

Jatan Bahadur Sherchan ◽

Sanjay Humagain

Keyword(s):

Tract Infection ◽

Respiratory Tract ◽

Respiratory Tract Infection ◽

Lower Respiratory Tract ◽

Multidrug Resistant ◽

P Value ◽

Diabetic Patients ◽

Gram Negative Bacteria ◽

Predisposing Factor ◽

Gram Negative

Background: Respiratory tract infection due to Gram-negative bacteria is a common cause of morbidity and mortality worldwide. This study was carried out to determine the antimicrobial susceptibility pattern of Gram-negative bacteria from patients with lower respiratory tract infection visiting Kathmandu University Hospital.Methods: A total of 3,403 respiratory samples including sputum and endotracheal aspirates were processed and antibiotic resistance pattern was determined following Clinical Laboratory Standard Institute guidelines. Patients’ information was obtained after informed consent.Results: Growth of Gram-negative bacteria was 210 (6.17%). 83(39.52%) were Klebsiella pneumoniae followed by Escherichia coli, Pseudomonas aeruginosa, Acinetobacter species, Klebsiella oxytoca, Enterobacter species, Proteus mirabilis and Haemophilus influenzae. 151(71.90%) isolates were multidrug resistant. None of the strains were resistant to colistin. 51(24.29%) were resistant to carbapenem and out of these 3(1.43%) were metallo-? lactamase producers. 89(65.92%) of the patients having both pneumonia along with other respiratory illnesses were above 60 years of age indicating that old age might be a predisposing factor. (p value is less than 0.0001). 92(81.42%) of patients of age above 60 years had multidrug resistant isolates indicating that old age might be a predisposing factor for getting infection my multidrug resistant isolates. (p value equals 0.0012) Among 36 diabetic patients 33(91.67%) had multidrug resistant isolates. Whereas out of 174 non-diabetic patients only 118(67.82%) had multidrug resistant isolates (p value equals 0.0037).Conclusions: Multidrug-resistant Gram negative bacteria were observed in respiratory samples. Effective treatment of lower respiratory tract infection need detailed microbiological diagnosis and drug susceptibility testing.Keywords: ESBL; LRTI; MBL; MDR

Download Full-text

Phenotypic and genotypic characterization of plasmid-mediated AmpC beta-lactamases in enteric Gram-negative bacteria from patients with lower respiratory tract infections in a tertiary hospital, southwest Nigeria

African Journal of Clinical and Experimental Microbiology ◽

10.4314/ajcem.v22i4.6 ◽

2021 ◽

Vol 22 (4) ◽

pp. 465-472

Author(s):

O.A. Thonda ◽

A.O. Oluduro ◽

O.O. Adewole ◽

P.O. Obiajunwa

Keyword(s):

Antibiotic Resistance ◽

Respiratory Tract ◽

Lower Respiratory Tract ◽

Respiratory Tract Infections ◽

Gram Negative Bacteria ◽

Lower Respiratory Tract Infections ◽

Gram Negative ◽

Beta Lactamases ◽

Tract Infections ◽

High Degree

Background: AmpC or class C or group 1 beta lactamases are class C cephalosporinases that hydrolyse a wide variety of beta-lactam antibiotics including alpha methoxy beta-lactams (cefoxitin), narrow and broad spectrum cephalosporins. This study was conducted to characterize plasmid-mediated AmpC producing enteric Gram- negative bacteria from patients with lower respiratory tract infections in Obafemi Awolowo University Teaching Hospital Complex (OAUTHC) Ile Ife, Osun State, NigeriaMethodology: A total of 149 patients with clinical features of lower respiratory tract infections (LRTI) were selected by simple random sampling for the study. All Gram-negative isolates recovered from standard microbiological cultures of respiratory specimens of these patients were tested against cefoxitin, third generation cephalosporins (3GCs), and other antibiotics using the disc diffusion AST method, and also screened for production of AmpC beta-lactamases phenotypically by the CLSI method. Plasmid DNA extraction was carried out on twenty-nine cefoxitin-resistant selected isolates using the Kado and Lin method, while genotypic detection of plasmid-mediated AmpC gene was carried out by the polymerase chain reaction (PCR) assay.Results: The results showed that 204 (43.3%) of 471 isolates recovered from the 149 selected patients were resistant to 3GC in the AST assay, among which 121 (59.3%) were resistant to cefoxitin, and 189 of the 471 isolates (40.1%) were AmpC producers. The AmpC producers concurrently showed multiple resistance pattern to other antibiotics tested in this study. Ninety six percent of the 29 selected isolates for plasmid analysis contained plasmids, 45% of which amplified positive on PCR for CMY, 38% for FOX, and 31% for ACC types of AmpC genes.Conclusion: This study showed a high degree of antibiotic resistance among enteric Gram-negative bacteria recovered from patients with LRTIs, as well as high degree of plasmid-encoded AmpC genes responsible for this high antibiotic resistance among the isolates. Proper antibiotic policy and regulation are required to limit the spread of plasmid mediated AmpC β-lactamase producing organisms because they can lead to therapeutic failure in infected patients in the nearest future. French title: Caractérisation phénotypique et génotypique des bêta-lactamases AmpC à médiation plasmidique dans les bactéries entériques Gram-négatives de patients atteints d'infections des voies respiratoires inférieures dans un hôpital tertiaire, sud-ouest du Nigéria Contexte: Les bêta-lactamases AmpC ou de classe C ou de groupe 1 sont des céphalosporinases de classe C qui hydrolysent une grande variété d'antibiotiques bêta-lactamines, y compris les alpha-méthoxy bêta-lactamines (céfoxitine), les céphalosporines à spectre étroit et large. Cette étude a été menée pour caractériser les bactéries à Gram négatif entériques produisant de l'AmpC à médiation plasmidique chez des patients atteints d'infections des voies respiratoires inférieures du complexe hospitalier universitaire d'Obafemi Awolowo (OAUTHC) Ile Ife, État d'Osun, NigériaMéthodologie: Un total de 149 patients présentant des caractéristiques cliniques d'infections des voies respiratoires inférieures (LRTI) ont été sélectionnés par échantillonnage aléatoire simple pour l'étude. Tous les isolats à Gram négatif récupérés à partir de cultures microbiologique standard d'échantillons respiratoires de ces patients ont été testés contre la céfoxitine, les céphalosporines de troisième génération (3GC) et d'autres antibiotiques en utilisant la méthode AST de diffusion sur disque, et également criblés pour la production de bêtalactamases AmpC phénotypiquement par le Méthode CLSI. L'extraction de l'ADN plasmidique a été réalisée sur 29 isolats sélectionnés résistants à la céfoxitine en utilisant la méthode Kado et Lin, tandis que la détection génotypique du gène AmpC à médiation plasmidique a été réalisée par le test de réaction en chaîne par polymérase (PCR).Résultats: Les résultats ont montré que 204 (43,3%) des 471 isolats récupérés des 149 patients sélectionnés étaient résistants à la 3GC dans le test AST, parmi lesquels 121 (59,3%) étaient résistants à la céfoxitine et 189 des 471 isolats (40,1%) étaient des producteurs d'AmpC. Les producteurs d'AmpC ont montré simultanément plusieurs profils de résistance à d'autres antibiotiques testés dans cette étude. Quatre-vingt-seize pour cent des 29 isolats sélectionnés pour l'analyse des plasmides contenaient des plasmides, dont 45% amplifiés positifs par PCR pour CMY, 38% pour FOX et 31% pour les types ACC des gènes AmpC.Conclusion: Cette étude a montré un degré élevé de résistance aux antibiotiques parmi les bactéries entériques Gram-négatives récupérées chez des patients atteints de LRTI, ainsi qu'un degré élevé de gènes AmpC codés par plasmide responsable de cette résistance élevée aux antibiotiques parmi les isolats. Une politique et une réglementation appropriées en matière d'antibiotiques sont nécessaires pour limiter la propagation des organismes producteurs β-lactamase d'AmpC à médiation plasmidique car ils peuvent conduire à un échec thérapeutique chez les patients infectés dans un avenir proche.

Download Full-text

High Rate of Multidrug-resistance Among Clinical Isolates of Gram-negative Bacteria in Hospitalized Patients With Febrile Diseases in Central Ethiopia

10.21203/rs.3.rs-743318/v1 ◽

2021 ◽

Author(s):

Tafese B Tufa ◽

Colin R Mackenzie ◽

Hans Martin Orth ◽

Tobias Wienemann ◽

Tamara Nordmann ◽

...

Keyword(s):

Antimicrobial Resistance ◽

Low Income ◽

Hospitalized Patients ◽

High Rate ◽

Empiric Antibiotic Therapy ◽

Clinical Samples ◽

Resistance Pattern ◽

Gram Negative Bacteria ◽

Gram Negative ◽

Central Ethiopia

Abstract Background Infectious diseases are among the leading causes of death in many low-income countries such as Ethiopia. Without reliable local data concerning causative pathogens and antimicrobial resistance, empirical treatment is suboptimal. The objective of this study was the characterization of Gram-negative bacteria (GNB) as pathogens and their resistance pattern in hospitalized patients with infections in Central Ethiopia. MethodsPatients ≥1 year of age with fever admitted to the Asella Referral and Teaching Hospital from April 2016 to June 2018 were included. Blood and other appropriate clinical specimens were collected and cultured on appropriate media. Antibiotic susceptibility testing (AST) was performed using the Kirby-Bauer method and VITEK® 2. Species identification and detection of resistance-genes were conducted using MALDI-ToF-MS (VITEK® MS) and PCR respectively. ResultsOf 684 study participants, 54.2% were male and median age was 22.0 (IQR: 14-35) years. Blood cultures were positive in 5.4% (n=37). In other clinical samples, cultures were positive in 60.6% (20/33), 20.8% (5/24), and 37.5% (3/8) in swabs/pus, urine and other body fluids, respectively. Of 66 pathogenic isolates, 57.6% (n=38) were GNB, (39.4% (n=26) Gram-positive and 3.0% (n=2) were candida species. Among the isolated GNB, 42.1% (16/38) were E. coli, 23.7% (9/38) K. pneumoniae and 10.5% (4/38) P. aeruginosa. In total, 27/38 Gram-negative isolates were available for further analysis. Resistance rates were: ampicillin/sulbactam 92.6% (n=25), cefotaxime 88.9% (n=24), ceftazidime 74.1% (n=20), cefepime 74.1% (n=20), gentamicin 55.6% (n=15), piperacillin/tazobactam 48.1% (n=13), meropenem 7.4% (n=2), and amikacin 3.7% (n=1). The NDM-1 gene was detected in one K. pneumoniae and one A. baumannii isolate, which carried an additional OXA-51 gene. Genes for ESBLs were detected in 81.5% (n=22) isolates as follows: TEM 77.2% (n=17), CTX-M-1-group 68.2% (n=15), SHV-group 27.3% (n=6) and CTX-M-9-group 9.1% (n=2). Clinical treatment data revealed ineffective antimicrobial treatment in 13 of 18 (72.2%) patients.ConclusionWe report a high prevalence of ESBL-producing bacteria (81.5%) and carbapenem-resistance (7.4%), with more than half of the GNB carrying two or more ESBL genes resulting in sub-optimal empiric antibiotic therapy. These findings indicate a need for local and national antimicrobial resistance surveillance and strengthening of antimicrobial stewardship programs.

Download Full-text

Serious Antimicrobial Resistance Status of Pathogens Causing Hospital-acquired Lower Respiratory Tract Infections in North China

Journal of International Medical Research ◽

10.1177/147323000903700336 ◽

2009 ◽

Vol 37 (3) ◽

pp. 899-907 ◽

Cited By ~ 6

Author(s):

Y Wang ◽

R Zhang ◽

W Li ◽

Y Feng ◽

T Leng

Keyword(s):

Antimicrobial Resistance ◽

Lower Respiratory Tract ◽

Respiratory Tract Infections ◽

Gram Negative Bacteria ◽

Lower Respiratory Tract Infections ◽

Gram Positive ◽

Gram Negative ◽

Gram Positive Bacteria ◽

Tract Infections ◽

Hospital Acquired

Antimicrobial resistance patterns of pathogens causing hospital-acquired lower respiratory tract infections (LRTIs) in Shandong Province, China were investigated using data collected from January 2002 to December 2006. A total of 10337 isolates were characterized in sputum samples from 39 920 LRTI patients: 68.72% were Gram-negative bacteria, 20.65% were Gram-positive bacteria, and 10.62% were fungi. Organisms most frequently isolated were: Pseudomonas aeruginosa (16.88%), Klebsiella pneumoniae (10.80%), Escherichia coli (10.71%), fungi (10.62%), Staphylococcus aureus (9.68%) and Acinetobacter baumannii (9.03%). Imipenem was the most effective antibiotic against Gram-negative bacteria. Most Gram-positive bacteria were susceptible to vancomycin. Susceptibility to cephalosporins was not optimal and resistance to fluoroquinolones was high. Resistance of Gram-negative bacteria showed a rapid increase over the study period, while resistance of Gram-positive bacteria remained relatively stable. The emergence of resistance to commonly prescribed antimicrobial agents used against LRTI pathogens has compounded the problem of using empirical therapy and created selective pressure on physicians to use certain antibiotics.

Download Full-text

Lower Respiratory Tract Pathogens and Their Antimicrobial Susceptibility Pattern: A 5-Year Study

Antibiotics ◽

10.3390/antibiotics10070851 ◽

2021 ◽

Vol 10 (7) ◽

pp. 851

Author(s):

Biagio Santella ◽

Enrica Serretiello ◽

Anna De Filippis ◽

Folliero Veronica ◽

Domenico Iervolino ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Pseudomonas Aeruginosa ◽

Klebsiella Pneumoniae ◽

Respiratory Tract ◽

Antimicrobial Susceptibility ◽

Lower Respiratory Tract ◽

Susceptibility Testing ◽

Gram Negative Bacteria ◽

Susceptibility Pattern ◽

Gram Negative

Lower respiratory tract infections (LRTIs) are the most common infections in humans. It is estimated that 2.74 million deaths worldwide occur each year due to LRTIs. The aim of the study was to determine the frequency and antibiotic susceptibility pattern of microorganisms isolated from respiratory samples of patients with LRTIs. Between January 2015 and December 2019, a total of 7038 sputum and bronchoaspirate samples from suspected LRTI patients were collected. Among them, 2753 samples (39.1%) showed significant microbial growth on culture media. The LRTI rate was higher in patients with male gender (67.1%) and with age between 40–59 years (48.6%). The microorganism identification and antibiotic susceptibility testing were performed with Vitek 2. Out of 4278 isolates species, 3102 (72.5%) were Gram-negative bacteria, 1048 (24.5%) were Gram-positive bacteria, and 128 (3.0%) were Candida spp. Major microorganisms isolated were Acinetobacter baumannii (18.6%), Staphylococcus aureus (15.2%), Pseudomonas aeruginosa (14.2%), and Klebsiella pneumoniae (10.9%). In antimicrobial susceptibility testing, Staphylococcus aureus isolates were mostly resistant to Penicillin G (84.1%) and Oxacillin (48.1%), whereas they demonstrated maximum sensitivity to Tigecycline (100%) and Linezolid (99.5%). Among Gram-negative isolates, Acinetobacter baumannii showed maximum sensitivity to Colistin but was resistant to other antibiotics (95–99%). Klebsiella pneumoniae isolates were mostly resistant to Cefotaxime (72.7%) and sensitive to Gentamicin (54.3%), and Pseudomonas aeruginosa was resistant to Ciprofloxacin (40.3%) and sensitive to Amikacin (85.9%). Gram-negative bacteria represented the species most commonly isolated. A high rate of antimicrobial resistance was observed in this study. In conclusion, the correct identification of causative microorganisms and their susceptibility patterns to antibiotics is crucial for choosing targeted and effective antibiotic therapy in LRTIs, and to prevent the emergence of multidrug-resistant bacteria.

Download Full-text

Current Trend in the Antibiogram of Bacterial Pathogens of Adult Lower Respiratory Tract Infections in a Nigerian Tertiary Hospital

Asian Journal of Research in Infectious Diseases ◽

10.9734/ajrid/2021/v8i330237 ◽

2021 ◽

pp. 10-18

Author(s):

Oluwalana T. Oyekale ◽

Bola O. Ojo ◽

Damilola E. Oguntunmbi ◽

Oluwatoyin I. Oyekale

Keyword(s):

Respiratory Tract ◽

Antibiotic Susceptibility ◽

Lower Respiratory Tract ◽

Respiratory Tract Infections ◽

Bacterial Pathogens ◽

Empirical Treatment ◽

Gram Negative Bacteria ◽

Lower Respiratory Tract Infections ◽

Gram Negative ◽

Tract Infections

Background: Lower respiratory tract infections (LRTIs) are among the commonest infectious diseases requiring hospitalization. There is an increasing resistance development of bacterial pathogens of LRTIs to the commonly prescribed antibiotics necessitating regular surveillance for these bacteria and their antibiogram. Aim: To identify bacterial pathogens of adult LRTIs, determine their antibiotic susceptibility pattern, and suggest the best empirical treatment of adult LRTIs in the setting. Study Design: Descriptive cross-sectional study. Methods: A total of 194 respiratory samples from 194 consecutive consenting adult in-patient of a Federal Teaching Hospital were processed. Identification of isolated bacteria and antibiotic susceptibility testing of the isolates were carried out following the standard protocol. Results: Bacteria isolation was seen in 52.1% of all specimens, highest isolation rate was from sputum (55.2%). Isolation was higher in males (54.9%) than females (48.1%) but no significant difference was seen (P=0.36). Gram negative bacteria were predominantly isolated (64.4%) and Klebsilla pneumoniae was the most common (33.7%). Eight extended-spectrum beta-lactamase (ESBL) producers and 3 methicillin-resistant Staphylococcus aureus (MRSA) were also detected. All isolates were sensitive to imipenem and meropenem. All MRSAs were sensitive to vancomycin. There was poor sensitivity pattern seen against most antibiotics tested. Conclusion: Gram negative bacteria were the predominant bacterial pathogen isolated, and isolates were resistant to most antibiotics tested, though, all were sensitive to carbapenems. Levofloxacin plus gentamicin, and carbapenems were the suggested first and second line empirical treatment of choice respectively for adult LRTIs in this and similar settings.

Download Full-text

Pathogenic Bacteria and Drug Sensitivity Analysis of Lower Respiratory Tract Infections in Patients

Advanced Emergency Medicine ◽

10.18686/aem.v3i1.2 ◽

2014 ◽

Vol 3 ◽

pp. 4

Author(s):

Qianqian Wang ◽

Chuanhui Wang

Keyword(s):

Internal Medicine ◽

Drug Resistance ◽

Tract Infection ◽

Respiratory Tract ◽

Respiratory Tract Infection ◽

Lower Respiratory Tract Infection ◽

Lower Respiratory Tract ◽

Pathogenic Bacteria ◽

Gram Negative Bacteria ◽

Gram Negative

Objective: To study drug resistance of pathogenic bacteria in lower respiratory tract infection in patients in Respiratory Department of Internal Medicine. Method: On October 2011 to October 2013, there were 112 patients with lower respiratory tract infection in the hospital respiratory medicine ward were reviewed for analysis by collected patient’s infected blood, urine and sputum for laboratory analysis and investigation of drug resistance. Results: In a total of 112 strains of pathogenic bacteria, gram negative bacteria, the number of strains was 68, accounting for 60.7% of all strains. The analysis of gram positive bacteria had the lowest drug resistance to vancomycin, but the resistance to erythromycin and penicillin was the highest, while gram negative bacteria were the lowest, but the drug resistance was high. Conclusion: In Respiratory Department Of Internal Medicine, patients with lower respiratory tract infection, the pathogenic bacteria which is gram negative bacterial infection is more common, to clarify the distribution of the infection of pathogenic bacteria, and the drug resistance to do a good grasp of the lower respiratory tract infection in patients with lower respiratory tract infection in patients with the role of a thing.

Download Full-text

Prevalence and characterization of antimicrobial resistance among gram-negative bacteria isolated from febrile hospitalized patients in central Ethiopia

Antimicrobial Resistance and Infection Control ◽

10.1186/s13756-022-01053-7 ◽

2022 ◽

Vol 11 (1) ◽

Author(s):

Tafese Beyene Tufa ◽

Colin R. Mackenzie ◽

Hans Martin Orth ◽

Tobias Wienemann ◽

Tamara Nordmann ◽

...

Keyword(s):

Antimicrobial Resistance ◽

Low Income ◽

Hospitalized Patients ◽

Empiric Antibiotic Therapy ◽

Clinical Samples ◽

Resistance Pattern ◽

Gram Negative Bacteria ◽

Gram Negative ◽

Central Ethiopia ◽

Empiric Treatment

Abstract Background Infectious diseases are among the leading causes of death in many low-income countries, such as Ethiopia. Without reliable local data concerning causative pathogens and antimicrobial resistance, empiric treatment is suboptimal. The objective of this study was to characterize gram-negative bacteria (GNB) as pathogens and their resistance pattern in hospitalized patients with infections in central Ethiopia. Methods Patients ≥ 1 year of age with fever admitted to the Asella Referral and Teaching Hospital from April 2016 to June 2018 were included. Blood and other appropriate clinical specimens were collected and cultured on appropriate media. Antibiotic susceptibility testing (AST) was performed using the Kirby–Bauer method and VITEK® 2. Species identification and detection of resistance genes were conducted using MALDI-ToF MS (VITEK® MS) and PCR, respectively. Results Among the 684 study participants, 54.2% were male, and the median age was 22.0 (IQR: 14–35) years. Blood cultures were positive in 5.4% (n = 37) of cases. Among other clinical samples, 60.6% (20/33), 20.8% (5/24), and 37.5% (3/8) of swabs/pus, urine and other body fluid cultures, respectively, were positive. Among 66 pathogenic isolates, 57.6% (n = 38) were GNB, 39.4% (n = 26) were gram-positive, and 3.0% (n = 2) were Candida species. Among the isolated GNB, 42.1% (16/38) were Escherichia coli, 23.7% (9/38) Klebsiella pneumoniae and 10.5% (4/38) Pseudomonas aeruginosa. In total, 27/38 gram-negative isolates were available for further analysis. Resistance rates were as follows: ampicillin/sulbactam, 92.6% (n = 25); cefotaxime, 88.9% (n = 24); ceftazidime, 74.1% (n = 20); cefepime, 74.1% (n = 20); gentamicin, 55.6% (n = 15); piperacillin/tazobactam, 48.1% (n = 13); meropenem, 7.4% (n = 2); and amikacin, 3.7% (n = 1). The blaNDM-1 gene was detected in one K. pneumoniae and one Acinetobacter baumannii isolate, which carried an additional blaOXA-51 gene. The ESBL enzymes were detected in 81.5% (n = 22) of isolates as follows: TEM, 77.2% (n = 17); CTX-M-1 group, 68.2% (n = 15); SHV group, 27.3% (n = 6); and CTX-M-9 group, 9.1% (n = 2). Based on the in vitro antimicrobial susceptibility results, empiric treatment initiated in 13 of 18 (72.2%) patients was likely ineffective. Conclusion We report a high prevalence of ESBL-producing bacteria (81.5%) and carbapenem resistance (7.4%), with more than half of GNB carrying two or more ESBL enzymes resulting in suboptimal empiric antibiotic therapy. These findings indicate a need for local and national antimicrobial resistance surveillance and the strengthening of antimicrobial stewardship programs.

Download Full-text