ABSTRACT
Objectives: To evaluate extended spectrum betalactamase [ESBL] in E.coli and Klebsiella pneumoniae in bacterial cultures and its frequency at LRH
Study Design: Cross sectional analytical study
Setting: Lady Reading Hospital, Peshawar
Period: June 2013 to December 2013
Methodology: Total of 1037 bacterial isolates including 614 E.coli and 423 of Klebsiellapneumoniae were evaluated. All cases were subjected to double disc diffusion method for ESBL detection using amoxacilln-clavulanic acid and a third generation cephalosporin as all ESBLs are hydrolysed by clavulanic acid. The data were analysed using SPSS-16
Results: Out of 1037 cases five ninety two [55%] were males and four fourty five [45%] were females. Of these, E. Coli were 614 [59.2%] and K. Pneumoniae were four twenty three [40.8%]. Of these 1037 isolates, four hundred and ninety five[47.7%] tested positive for ESBL enzyme. Frequency of ESBL positivity in E.coli isolates was 264 [43%] and in Klebsiellapneumoniae isolates was 231 [54.6%].Frequency of ESBL in pus was 34.3%[152/395],in urine, it was 31.8%[141/368], in blood it was 28.6%[127/233] and in sputum it was 5.1% [23/41]. Unit wise frequency of ESBL was surgical and allied 24.6% [109/283], medical and allied 21.4%[95/241], paediatrics 18.5% [82/203], obstetrics and gynaecology 23.2%[103/178] and outpatients 12.1%[54/132]. No significant correlation between ESBL positivity, gender, unit or specimen was found
Conclusion: ESBL positive isolates of E.coli and K.pneumoniaeshould be properly detected in routine laboratory workflow to avoid unnecessary use of otherwise effective antibiotics. These results indicate that such organisms are highly prevalent in our Hospital and need immediate
ABSTRACT
Objectives: to detect extended spectrum beta lactamase in E. coli and Klebsiella pneumonia in bacterial cultures and its frequency at Lady Reading Hospital, Peshawar
Methodology: this cross sectional analytical study was conducted at LRH between June 2013 to December 2013, a total of 1037 bacterial isolates in-cluding 614 E. coli and 423 of Klebsiella pneumoniae were evaluated. All cases were subjected to double disc diffusion method for ESBL detection using amoxacilln-clavulanic acid and a third generation cephalosporin as all ESBLs are hydrolysed by clavulanic acid. The data were analysed using SPSS-16
Results: patients' mean age was 40 years. Out of 1037 cases, 592 [55%] were males and 445 [45%] were females. Of these, E. Coli were 614 [59.2%] and K. Pneumoniae were 423 [40.8%].Frequency of ESBL positivity in E. coli isolates was 264 [43%] and in Klebsiella pneumonia isolates was 231 [54.6%].Frequency of ESBL in pus was 34.3%[152/395],in urineit was 31.8%[141/368], in blood it was 28.6%[127/233] and in sputum it was 5.1% [23/41].Unit-wise frequency of ESBL was surgical and allied 24.6%[109/283], medical and allied 21.4% [95/241], paediatrics 18.5%[82/203], obstetrics andgynaecology23.2% [103/178] and outpatients 12.1%[54/132]. No significant correlation between ESBL positivity and age, gender, unit or specimen was found
Conclusion: ESBL positive isolates of E. coli and K. pneumoniae account for a very high percentage of hospital-acquired infections. These results should be considered while prescribing penicillins and cephalosporins for treating gram-negative acquired infections