Mirsalehian.A, Nakhjavani.F, Peymani.A, JabalAmeli.F, Mirafshar.S M, Hamidian.M. Frequency of extended spectrum β-Lactamase producing Enterobacteriaceae in intensive care units. Tehran Univ Med J 2008; 65 (1) :33-38
URL:
http://tumj.tums.ac.ir/article-1-843-en.html
Abstract: (7628 Views)
Background: The incidence of ESBL producing species have been steadily increased in
recent years, resulting in limitation of infection control issues and therapeutic
options.The purpose of this study was to evaluate prevalence of Enterobacteriaceae and
also assess epidemiology ESBL producing strains isolated from patients admitted in
ICUs.
Methods: A total of one hundred fifty isolates were collected from urine, sputum, blood,
wound and other clinical samples from patient admitted in ICU and then were identified
by biochemical tests .All of the samples were screened by DAD method according to The
NCCLS Guideline. The species that met NCCLS screening criteria was further tested for
Clavulanic Acid effect by confirmatory method.
Results: A total of one hundred fifty isolates,133(89.3%) were found to be resistant at
least on of the indicators cephalosporin tested according to NCCLS Guideline.
121(80.6%) of the isolates were resistant to all the indicators tested .89(59.3) isolateds
were confirmed as ESBL producers. The number of isolates ESBL producing was as
follow: Klebsiella pneumoniae 33 (76.74%), E.coli 20 (60.60%), Enterobacter cloacae 8
(47.05%), Citrobacter diversus 6 (54.54%), Enterobacter aerogenes 7 (53.84%),
Citrobacter freundii 4 (40%), Klebsiella oxytoca 6 (62.5%), Proteus mirabilis 4 (50%),
Serratia marcescens 2 (40%), Proteus Volgaris 0%.All of the isolates sensitive to
imipenem.
Conclusion: The present study shows high prevalence of ESBL producing
Enterobacteriaceae from patients admitted in ICU .The increased rate of these species in
most cases due to the administration of inadequate and irrational antimicrobial therapy
.To overcome this problem, it needs to develop new antimicrobial agents, limiting the
Unnecessary Use of antimicrobial and increasing compliance with infection control
issues.