Nasher Samar, Alsharapy Sameer, Al-Madhagi Anwar, Zakham Fathiah
National Center of Public Health Laboratories, Sana'a, Yemen.
Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen.
J Infect Dev Ctries. 2018 Nov 30;12(11):953-959. doi: 10.3855/jidc.10560.
Infection with Extended spectrum β-lactamases (ESBLs) producing bacteria is considered as serious health problem worldwide. The aim of this cross-sectional study was to investigate the prevalence of ESBL producing Escherichia coli in hospitalized patients and the risk factors contributed for its nosocomial infections in addition to the antibiotics susceptibility patterns of isolates from 130 inpatients collected in Al Thawra General Hospital and Al-Kuwait University Hospital in Sana'a city.
Antibiotic susceptibility testing and confirmation of ESBL production were performed according to the Clinical and Laboratory Standards Institute guidelines.
Out of 130 E. coli isolates, 44 (33.8%) were ESBLs producers, the majority of ESBLs producers were in wound exudates samples (52.2%). The highest significant rates were among the elderly, patients with previous hospitalization, patients who have stayed in hospital more than 22 days, patients who have taken third generation cephalosporins as treatment and diabetic patients. All ESBL-producing isolates were resistant to amoxicillin, trimethoprim-sulfamethoxazole and the third generation cephalosporins (100%). Resistance to other antimicrobial agents among these isolates was: amoxicillin-clavulanic acid (90.9%), nalidixic acid (95.5%), ciprofloxacin (90.9%), ofloxacin (88.6%) and tetracycline (54.5%). The most effective antibiotics in vitro for both types of isolates (ESBL producing and non ESBL producing E. coli) were Imipenem (100%), Amikacin (75%) and (93.0%), respectively, and Pipracillin-tazobactam (68.2%) and (88.4%), respectively.
ESBLs detection tests must be performed as routine work in all hospitals and laboratories. Furthermore, a strict adherence of infection control policies and procedures with continuous antibiotics resistance surveillance are important to prevent nosocomial infections.
产超广谱β-内酰胺酶（ESBLs）细菌的感染被认为是全球范围内严重的健康问题。这项横断面研究的目的是调查萨那市的宰赫拉综合医院和科威特大学医院收治的130例住院患者中产ESBLs大肠杆菌的流行情况、其医院感染的危险因素以及分离菌株的抗生素敏感性模式。
根据临床和实验室标准协会的指南进行抗生素敏感性测试和ESBLs产生的确认。
在130株大肠杆菌分离株中，44株（33.8%）产ESBLs，大多数产ESBLs菌株存在于伤口渗出液样本中（52.2%）。最高的显著比例出现在老年人、既往住院患者、住院时间超过22天的患者、接受第三代头孢菌素治疗的患者以及糖尿病患者中。所有产ESBLs分离株对阿莫西林、甲氧苄啶-磺胺甲恶唑和第三代头孢菌素均耐药（100%）。这些分离株对其他抗菌药物的耐药情况为：阿莫西林-克拉维酸（90.9%）、萘啶酸（95.5%）、环丙沙星（90.9%）、氧氟沙星（88.6%）和四环素（54.5%）。对两种类型分离株（产ESBLs和不产ESBLs的大肠杆菌）体外最有效的抗生素分别是亚胺培南（100%）、阿米卡星（75%）和（93.0%）以及哌拉西林-他唑巴坦（68.2%）和（88.4%）。
所有医院和实验室必须将ESBLs检测作为常规工作进行。此外，严格遵守感染控制政策和程序并持续进行抗生素耐药性监测对于预防医院感染很重要。
