Abstract
PREVALENCE OF ESBL PRODUCING GRAM NEGATIVE BACTERIA AND DETERMINE THE ANTIBIOTIC SUSCEPTIBILITY PATTERN OF ESBL PRODUCING E. COLI IN ADEN CITY-YEMEN

*Mohammed A. A. Al-Baghdadi

ABSTRACT

Background: Extended spectrum β-lactamase (ESBL) producing Enterobacteriaceae has tremendously increased worldwide and it is one of the most common causes of morbidity and mortality associated with hospital and community-acquired infections. This could be attributed to association of multidrug resistance in ESBL producing bacteria. The present study was aimed to determine the prevalence of ESBL among Gram negative bacteria isolated from private clinical laboratories in Aden city-Yemen and determine the antimicrobial sensitivity profile of ESBL producing E. coli isolates from various clinical samples. Since there no such published data. Materials and Methods: A cross-sectional study was conducted during the study period from 12th January to 12th April 2018. Clinical samples, which consist of pus, urine, stool, sputum, throat swabs, and semen, were collected according to standard procedures and transported without delay. Samples were processed and identified as per routine laboratory protocol. ESBL screening test and confirmation by double disk diffusion test (DDDT) along with antimicrobial susceptibility test was done according to the Clinical Laboratory Standards Institute (CLSI) guidelines. Results: A total number of 114 clinical specimens of Gram negative bacteria were obtained from different clinical samples. The age of such patients were ranged from less than one year up to 40 years of age. Seventy nine (69.3%) were male and 35(30.7%) were female. Out of 114 Gram negative isolates in this study majority was Escherichia coli 85(74.6%) followed by Klebsiella spp. 14(12.3%), while Pseudomonas spp. and Proteus spp. were obtained in 8(7%) and 7(6.1%), respectively. In the combined disk test, 75(65.8%) isolates were ESBL producers. The higher occurrence of ESBL producing E. coli 60(80%), Klebsiella spp. 8(10.7%), Proteus spp. 4(5.3%), and pseudomonas spp. 3(4%) from various clinical isolates. Out of the 75 positive ESBL and the 39 negative ESBL the resistance pattern to Beta-Lactam drugs were: Cefuroxime (81.3% & 41%), Cefixime (88% & 38.5%), Cefpodoxime (100% & 94.9%), Ceftriaxone (100% & 41%), Cefotaxime (89.3% & 56.4%), Aztreonam (98.7% & 25.6%) and Imipenem (10.7% & 7.7%), while Aminoglycosides: Amikacin (20% & 10.3%) and Gentamycin (25.3% & 17.9%), in addition, the Fluoroquinolones: Ciprofloxacin (34.7% & 30.8%), Ofloxacin (52% & 33.3%) and Norfloxacin (37.3% & 23.1%). Conclusion: Results indicate that routine ESBL detection should be made mandatory by both combined methods and strains should be taken both 3rd Generation Cephalosporins sensitive and resistant. Irrational use of 3rd generation cephalosporins must be discouraged to reduce multidrug resistant bacteria, to increase patients` compliance and to make an antibiotic policy.

Keywords: ESBL, E. coli, ESBL producing E. coli, DDDT.


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