ABSTRACT
To determine the prevalence of extended-spectrum bi-lactamases [ESBLs] among the bacteria of family Enterobacteriaceae isolated from Nosocomial and outpatients, with double disc diffusion / synergy test. The bacterial strains were isolated from pus, sputum, blood, urine, pleural fluid, peritoneal fluid and cerebro-spinal fluid samples, obtained from both Nosocomial and outpatients. The samples were obtained from patients admitted in oncology, post-operative surgical, kidney transplant center / urology wards and intensive care unit of Pakistan Institute of Medical Sciences as well as outpatients of the hospital. Bacterial isolates, of family Enterobacteriaceae, were obtained from 200 Nosocomial and 200 outpatients [ambulatory]. The isolates were sub-cultured, identified, and the double disc diffusion / synergy test was performed for detection of ESBLs. Double disc diffusion / synergy test, for the detection of ESBLs production in Enterobacteriaceae. Prevalence of ESBLs in the Enterobacteriaceae was found to be 37.50% in Nosocomial and 06% in outpatient isolates. Highest prevalence was seen in Klebsiella pneumoniae [70%], followed by Enterobacter cloacae [33.33%] and Escherichia coli [28.57%] in case of Nosocomial isolates while in case of out-patient [ambulatory] isolates, the Enterobacter cloacae are the most prevalent ESBLs producers [8.33%]. Conclusions: Prevalence of ESBLs among the bacteria of family Enterobacteriaceae was higher in isolates obtained from Nosocomial patients as compared to out-patient [ambulatory] isolates. Such type of antimicrobial resistance appears to be particularly influenced by irrational use of antibiotics. To overcome this problem, the combined competencies of clinicians, microbiologists and the infection control team are needed