Extended spectrum b-lactamase-producing Klebsiella pneumoniae and Escherichia coli strains in a pediatric teaching hospital in Egypt (original) (raw)

The aim of this study is to study the prevalence of extended spectrum b-lactamase (ESBL)-producing Escherichia coli (ESBL-E) and Klebsiella pneumoniae (ESBL-K) and the clonality of isolates causing nosocomial infections in our hospital. Materials and methods A cross-sectional study was conducted; clinical isolates of E. coli and K. pneumoniae were screened for ESBL production. In addition, the clonal relationship of nosocomial ESBL-E and ESBL-K was studied by biotyping and antimicrobial susceptibility testing, which was confirmed by pulsed-field gel electrophoresis. Results Of the 5976 clinical specimens (3048 blood, 1296 urine, 924 sputum, 312 pus, 396 other types of specimens) submitted for bacterial culture, a total of 156 E. coli and 300 K. pneumoniae were isolated. ESBL-E and ESBL-K represented 86% and 68.3%, respectively, of the total E. coli and K. pneumoniae. Antimicrobial susceptibility testing to non-b-lactam agents, including amikacin, gentamicin, cotrimoxazole, and ciprofloxacin, for ESBL-E were 75.7, 79.4, 19.7, and 100%, respectively, and for ESBL-K were 66.5, 42, 24.3, and 31%, respectively. Ten (7.5%) of the 134 ESBL-E and 29 (15%) of the 192 ESBL-K proved to be identical by biotyping and antimicrobial susceptibility testing. Pulsed-field gel electrophoresis of the identical isolates revealed two and seven clones, respectively. Conclusion The results of this study suggest the endemicity of ESBL-producing K. pneumoniae and E. coli strains and the dissemination of a plasmid rather than the occurrence of a clonal outbreak during the study period.