Prevalence of extended-spectrum beta-lactamase-producing enterobacteriaceae in Bahrain

ABSTRACT

To determine the occurrence of extended-spectrum beta-lactamase [ESBL]-producing Enterobacteriaceae in Bahrain. Retrospective analysis of records [January 2005-December 2006] at the Microbiology Laboratory of the Salmaniya Medical Complex, Bahrain which is the major national diagnostic laboratory. Out of a total of 11,886 member of family of Enterobacteriaceae isolated, 2695 [22.6%] were ESBL producers. Majority of ESBL isolates were from inpatients [n = 2363; 87.7%]. Escherichia coli [52.2%] and Klebsiella pneumoniae [24.3%] were predominant and distributed comparatively in the hospital wards while Proteus spp. [17.6%] was predominant in medical wards. Urine was the major source [52.2%] with low occurrence in blood cultures. No carbapenem resistant isolates was identified but resistance to three classes of antibiotics was exhibited by >25% of the isolated ESBL strains. Nitrofurantoin resistance was identified in 38.2% of urinary isolates. This is the first report from Bahrain and it indicates that the prevalence of ESBL-producing isolates is high. Carbapenems were the most active drug against the ESBL-producing isolates. We recommend strict infection control to prevent trafficking into the community