ESBL PRODUCING STRAINS IN KHORRAMABAD Cross-sectional study of extended spectrum beta-lactamase producing gram-negative bacilli from clinical cases in Khorramabad, Iran


Introduction: Antibiotic resistance among bacteria in particular those producing Extended Spectrum Beta lactamases (ESBLs) has a very significant role in hospital acquired infections. Some of the gram negative bacilli including Klebsiella pneumonia and Escherichia coli are known to be ESBL producers which cause uncontrollable infections because they are also often resistant to other antimicrobial agents. This study was designed to assess the ESBL producing gram-negative bacilli among clinical isolates of inpatients at Shohada-ye Ashayer Hospital, Khorramabad, Iran. Materials and Methods: Samples were processed with routine laboratory methods and gram-negative bacilli were identified by standard tests. ESBL producing gram-negative bacilli were screened by MacConkey Agar containing 4 mg/liter ceftazidime and confirmed with the double disk synergy method. Results: Fifty-three cases (23.6%) of 225 total isolated gram-negative bacilli were positive in terms of ESBL production. Klebsiella pneumoniae comprising 20 cases (8.9%) was the dominant organism producing ESBLs followed by Escherichia coli (10 cases; 4.4%) and Pseudomonas aeruginosa (10 cases; 4.4%). The most ESBL producing organisms were found in urine samples (21 cases; 39.6%). Ten cases (18.9%) of isolates were from samples collected with sterile bronchoscopy. Conclusion: Results of the study indicated that ESBL producing gram negative bacilli are frequently isolated from Shohadaye Ashaier Hospital. Regarding the high resistance of these strains against many of the antibiotics and even against carbapenems, health care professionals need to plan policies to fight the induction and spread of such strains.


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