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Article Type

Original Study

Abstract

Objective The aim of the study was to evaluate the prevalence of extended-spectrum β-lactamase (ESBLs) in Enterobacteriaceae among patients conducted at Menoufia University Hospitals. Background Resistance to β-lactam antibiotics is an increasing problem, and β-lactamase production is the most common mechanism of drug resistance, especially in Enterobacteriaceae. The Clinical and Laboratory Standard Institute (CLSI) interpretive guidelines stated that Enterobacteriaceae that produce ESBLs are resistant to therapy with penicillin, cephalosporins, and aztreonam, despite apparent in-vitro susceptibility to some of these agents. Therefore, detection of ESBLs in Enterobacteriaceae is crucial for optimal treatment of patients and to control the spread of resistance. Patients and methods The isolated strains of Enterobacteriaceae are subjected to phenotype detection by screening for ESBLs by disk diffusion test then to confirmatory tests for ESBLs by double disk test. Results A total of 97 of 160 (60.6%) isolates were found to be ESBL producers by the CLSI confirmatory method. Of 97 ESBL producers, 45 (46.4%) were Escherichia coli, 28 (28.9%) were Enterobacter spp., and 22 (22.7%) were Klebsiella spp. Of the various clinical samples, the most frequent ESBLs isolates were from urine samples (27.8%), followed by sputum samples (18.6%). Conclusion High prevalence of ESBL producers in our hospital (60.6%) calls for strict policies regarding antibiotic usage and their screening methods, and hospital-based clinical laboratories should screen isolates following hospitalization in patients in need for antibiotics to formulate effective antibiotic strategy and plan a proper hospital infection control strategy to prevent the spread of these ESBL strains.

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