ESBL-producing Escherichia coli and Klebsiella pneumoniae at a tertiary care hospital in Saudi Arabia

  • Ali Mohammed Somily King Saud University Hospital, Riyadh, Saudi Arabia
  • Hanan A Habib King Saud University Hospital, Riyadh, Saudi Arabia
  • Muhammad M Absar King Saud University Hospital, Riyadh, Saudi Arabia
  • Muhammad Z Arshad King Saud University Hospital, Riyadh, Saudi Arabia
  • Kutubu Manneh King Saud University Hospital, Riyadh, Saudi Arabia
  • Sarah S Al Subaie King Saud University Hospital, Riyadh, Saudi Arabia
  • Mogbil A Al Hedaithy King Saud University Hospital, Riyadh, Saudi Arabia
  • Samina B Sayyed King Saud University Hospital, Riyadh, Saudi Arabia
  • Zahid Shakoor King Saud University Hospital, Riyadh, Saudi Arabia
  • Thomas S Murray Yale School of Medicine, New Haven and Department of Medical Sciences, Frank H. Netter, M.D., School of Medicine at Quinnipiac University, United States
Keywords: Escherichia coli, Klebsiella pneumoniae, extended-spectrum beta-lactamases, susceptibility, antibiotics

Abstract

Introduction: The increasing frequency  and antibiotic resistance among extended-spectrum β-lactamases (ESBLs)-producing bacteria are posing a serious threat. This study sought to investigate the frequency and antibiotic susceptibility of ESBL-producing E. coli and K. pneumoniae at a tertiary care hospital.

Methodology: Data were collected from samples sent to the microbiology laboratory between 2006 and 2010 at King Khalid University Hospital, Riyadh. ESBLs were confirmed using Etest strips of cefotaxime/cefotaxime + clavulanic acid, ceftazidime/ceftazidime + clavulanic acid, and cefepime/cefepime + clavulanate.

Results: Out of 17,105 samples, 1,076 (6.3%) ESBL-producing isolates of E. coli (808) and K. pneumoniae (268) were confirmed. Among these, 680 (63.2%) isolates were found in urine samples, followed by 287 (26.7%) in superficial swabs, deep wounds swabs, tissues and sterile body fluids, 71 (6.6%) in respiratory, and 38 (3.5%) in blood samples. The overall frequency rates of ESBL E. coli and K. pneumoniae were 6.6% and 5.5%, respectively. The frequency of ESBL-producing E. coli and K. pneumoniae increased significantly during the study period. E. coli resistance against cotrimoxazole was 71.1%, followed by ciprofloxacin (68.2%) and gentamicin (47%). Similarly, 62.7% of K. pneumoniae isolates were resistant to gentamicin, 59.5% to cotrimoxazole, and 49.8% to ciprofloxacin. There was no statistically significant change in antimicrobial resistance over the study period.

Conclusions: Although the frequency rates of ESBL-producing E. coli and K. pneumoniae increased, no change in the anti-microbial susceptibility was observed over the study period.

Author Biographies

Ali Mohammed Somily, King Saud University Hospital, Riyadh, Saudi Arabia
Department of Pathology and laboratory Medicine, microbiology Unit College of Medicine and King Khalid University Hospital and Member of the biological research team at Dental carries research chair, College of Dentistry King Saud University  Riyadh, Saudi Arabia
Hanan A Habib, King Saud University Hospital, Riyadh, Saudi Arabia
Department of Pathology and laboratory Medicine and Microbiology Unit, King Saud University College of Medicine and King Khalid University Hospital Riyadh, Saudi Arabia
Muhammad M Absar, King Saud University Hospital, Riyadh, Saudi Arabia
Department of Pathology and laboratory Medicine and Microbiology Unit, King Saud University College of Medicine and King Khalid University Hospital Riyadh, Saudi Arabia
Muhammad Z Arshad, King Saud University Hospital, Riyadh, Saudi Arabia
Department of Pathology and laboratory Medicine and Microbiology Unit, King Saud University College of Medicine and King Khalid University Hospital Riyadh, Saudi Arabia
Kutubu Manneh, King Saud University Hospital, Riyadh, Saudi Arabia
Department of Pathology and laboratory Medicine and Microbiology Unit, King Saud University College of Medicine and King Khalid University Hospital Riyadh, Saudi Arabia
Sarah S Al Subaie, King Saud University Hospital, Riyadh, Saudi Arabia
Department of pediatrics and infection control, King Saud University College of Medicine and King Khalid University Hospital Riyadh, Saudi Arabia
Mogbil A Al Hedaithy, King Saud University Hospital, Riyadh, Saudi Arabia
Department of Medicine, King Saud University College of Medicine and King Khalid University Hospital Riyadh, Saudi Arabia.
Samina B Sayyed, King Saud University Hospital, Riyadh, Saudi Arabia
Department of Pathology and laboratory Medicine and Microbiology Unit, King Saud University College of Medicine and King Khalid University Hospital Riyadh, Saudi Arabia
Zahid Shakoor, King Saud University Hospital, Riyadh, Saudi Arabia
Department of Pathology and laboratory Medicine and Microbiology Unit, King Saud University College of Medicine and King Khalid University Hospital Riyadh, Saudi Arabia
Thomas S Murray, Yale School of Medicine, New Haven and Department of Medical Sciences, Frank H. Netter, M.D., School of Medicine at Quinnipiac University, United States
Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT and Department of Medical Sciences, Frank H. Netter, M.D., School of Medicine at Quinnipiac University.
Published
2014-09-12
How to Cite
1.
Somily AM, Habib HA, Absar MM, Arshad MZ, Manneh K, Al Subaie SS, Al Hedaithy MA, Sayyed SB, Shakoor Z, Murray TS (2014) ESBL-producing Escherichia coli and Klebsiella pneumoniae at a tertiary care hospital in Saudi Arabia. J Infect Dev Ctries 8:1129-1136. doi: 10.3855/jidc.4292
Section
Original Articles