Cross-sectional study of extended spectrum beta-lactamase producing gram-negative bacilli from clinical cases in Khorramabad, Iran
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Abstract
Introduction: Antibiotic resistance among bacteria in particular those producing Extended Spectrum Beta lactamases (ES- BLs) has a very significant role in hospital acquired infections. Some of the gram negative bacilli including Klebsiella pneu- monia 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 ceftazi- dime 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 Shohada- ye Ashaier Hospital. Regarding the high resistance of these strains against many of the antibiotics and even against carbapen- ems, health care professionals need to plan policies to fight the induction and spread of such strains.
Paterson DL .Bonomo RA .Extended-spectrum beta- lactamases :a clinical update .Clin Microbiol Rev 2005;18: 657-686.
Farber J, Moder KA, Layer F, Tammer I, König W, König B. Extended-spectrum beta-lactamase detection with different panels for automated susceptibility testing and with a chromogenic medium. J Clin Microbiol 2008; 46: 3721-3727.
Bush K, Jacoby GA, Medeiros AA. A functional classification scheme for beta-lactamases and its correlation with molecular structure. Antimicrob Agents Chemother 1995; 39: 1211-1233.
Thomson KS, Prevan AM, Sanders CC. Novel plasmid- mediated beta-lactamases in enterobacteriaceae: emerging problems for new beta-lactam antibiotics. Curr Clin Top Infect Dis 1996; 16: 151-63.
Harris AD,Kotetishvili M, Shurland S, Johnson JA, Morris JG, Nemoy LL et al. Patient-to-patient transmission is important in extended-spectrum beta- lactamase-producing Klebsiella pneumoniae acquisition. Clin Infect Dis 2007; 45: 1347-1350.
Ghanaat, J. and A. Sadeghian, Microbial resistance to hospital infections. Iran J Otorhinolaringol 2000;27: 54 - 44.
Mojtabaei SH, Noor Salehi E. Survey on efficacy of antibiotics in gram-negative septicemia in neonates and children. J of Medical Faculty, Guilan University of Medical Sciences 2003; 50:3 44-349.
Ramazanzadeh, R., M. Chitsaz, and N. Bahmani.Prevalence and antimicrobial susceptibility of extended- spectrum beta-lactamase-producing bacteria in intensive care units of sanandaj general hospitals (Kurdistan, Iran). Chemotherapy 2009; 55: 287-292.
Mirzaee M, Owlia P, Mansouri S. Distribution of CTX-M beta-lactamase genes among Escherichia coli strains isolated from patients in Iran. Labmedicine 2009;40: 724 -727.
Feizabadi MM, Fathollahzadeh B, Taherikalani M, Rasoolinejad M, Sadeghifard N, Aligholi M, Soroush S et al. Antimicrobial susceptibility patterns and distribution of bla (OXA) genes among Acinetobacter spp. isolated from patients at Tehran hospitals. Jpn J Infect Dis 2008; 61: 274 -278.
Shahcheraghi F, Nikbin VS, Feizabadi MM. Prevalence of ESBLs genes among multidrug-resistant isolates of Pseudomonas aeruginosa isolated from patients in Tehran. Microb Drug Resist 2009; 15: 37-39.
Cheong, Y.M.,Lim VK, Jegathesan M, Suleiman AB.. Antimicrobial resistance in 6 Malaysian general hospitals. Med J Malaysia 1994; 49: 317-26.2000; 12: 145-152.
M'Zali FH, Chanawong A, Kerr KG, Birkenhead D, Hawkey PM. Detection of extended-spectrum beta- lactamases in members of the family enterobacteriaceae: comparison of the MAST DD test, the double disc and the Etest ESBL. J Antimicrob Chemother 2000; 45: 881-885.
Shen D, Winokur P, Jones RN. Characterization of extended spectrum beta-lactamase-producing Klebsiella pneumoniae from Beijing, China. Int J Antimicrob Agents 2001; 18: 185-188.
Gulay Z, Thomson CJ, Yulug N, Amyes SG. High prevalence of extended spectrum beta-lactamase production among Klebsiella pneumoniae strains isolated at a University Hospital in Turkey. J Chemother Prevalence of extended-spectrum beta lactamase positive and multidrug resistance pattern of Escherichia coli and Klebsiella pneumoniae isolates, Semnan, Iran. Iran J Microbiol 2009; 1: 49-53.
Steward CD, Rasheed JK, Hubert SK, Biddle JW, Raney PM, Anderson GJ et al. Characterization of clinical isolates of Klebsiella pneumoniae from 19 laboratories using the National Committee for Clinical Laboratory Standards extended-spectrum beta-lactamase detection methods. J Clin Microbiol 2001; 39: 2864 -2872.
Coudron PE, Moland ES, Sanders CC. Occurrence and detection of extended-spectrum beta-lactamases in members of the family Enterobacteriaceae at a veterans medical center: seek and you may find. J Clin Microbiol 1997; 35: 2593-257.
Irajian GA, Jazayeri-Moghadas A, Beheshti A . Prevalence of extended-spectrum beta lactamase positive and multidrug resistance pattern of Escherichia coli and Klebsiella pneumoniae isolates, Semnan, Iran. Iran J Microbiol 2009; 1: 49-53.
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| Issue | Vol 1 No 3 (2009) | |
| Section | Articles | |
| Keywords | ||
| Hospital acquired infection Escherichia coli Klebsiella pneumoniae ESBL Khorramabad Iran | ||
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