A retrospective chart review study on the prevalence of extended spectrum β-lactamases producing bacteria among ICU patients in a tertiary care hospital in Saudi Arabia
Keywords:ESBL, Antibiotic resistance, Antibiotic sensitivity, KFSH, Beta lactams
Background: Antimicrobial resistance is a big concern that face the world. Every class of antibiotics agent has a unique resistant mechanism. The dominant mechanism for resistance to the β-lactam antibiotics in gram-negative bacteria is the production of β-lactamase. Extended-spectrum β-lactamases (ESBLs) production is an important mechanism which is responsible for the resistance to the third generation cephalosporins.
Methods: This is a retrospective study which was carried out in the intensive care unit department of King Fahad Specialist Hospital (KFSH), Buraydah, Kingdom of Saudi Arabia (KSA) to estimate the prevalence and associated risk factors of Extended-spectrum β-lactamase producing bacteria (ESBL) among Intensive care unit (ICU) patients.
Results: Our study showed that K. pneumoniae (50%) and E. coli (24.7%) were the most commonly isolated organisms as well as some high resistance rate to Meropenem and colistin. This rapid increase of resistance and decrease in sensitivity puts health care works at a serious problem and they must take urgent actions to face it.
Conclusions: Focusing more on the right use and good practice of antibiotics, such as prescribing and dispensing antibiotics only when they are needed according to the most recent guidelines, is also need of hour.
Paterson DL, Hujer KM, Hujer AM, Yeiser B, Bonomo MD, Rice LB, et al. Extended-spectrum beta-lactamases in Klebsiella pneumoniae bloodstream isolates from seven countries: dominance and widespread prevalence of SHV- and CTX-M-type beta-lactamases. Antimicrob Agents Chemother. 2003;47(11):3554-60.
Massart N, Camus C, Benezit F, Moriconi M, Fillatre P, Tulzo Y. Incidence and risk factors for acquired colonization and infection due to extended-spectrum beta-lactamase-producing Gram-negative bacilli: a retrospective analysis in three ICUs with low multidrug resistance rate. Eur J Clin Microbiol Infect Dis. 2020;39(5):889-95.
Garni SM, Ghonaim MM, Ahmed MMM, Ghamdi AS, Ganai FA. Risk factors and molecular features of extended-spectrum beta-lactamase producing bacteria at southwest of Saudi Arabia. Saudi Med J. 2018;39(12):1186-94.
Obeid S, Jabri L, Agamy M, Omari A, Shibl A. Epidemiology of extensive drug resistant Acinetobacter baumannii (XDRAB) at Security Forces Hospital (SFH) in Kingdom of Saudi Arabia (KSA). J Chemother. 2015;27(3):156-62.
Blom A, Ahl J, Månsson F, Resman F, Tham J. The prevalence of ESBL-producing Enterobacteriaceae in a nursing home setting compared with elderly living at home: a cross-sectional comparison. BMC Infect Dis. 2016;16:111.
Khizzi NA, Bakheshwain SM. Prevalence of extended-spectrum beta-lactamases among Enterobacteriaceae isolated from blood culture in a tertiary care hospital. Saudi Med J. 2006;27(1):37-40.
Shakya P, Shrestha D, Maharjan E, Sharma VK, Paudyal R. ESBL Production Among E. coli and Klebsiella spp. Causing Urinary Tract Infection: A Hospital Based Study. Open Microbiol J. 2017;11:23-30.
Yousefipour M, Rasoulinejad M, Hadadi A, Esmailpour N, Abdollahi A, Jafari S, et al. Bacteria Producing Extended Spectrum β-lactamases (ESBLs) in Hospitalized Patients: Prevalence, Antimicrobial Resistance Pattern and its Main Determinants. Iran J Pathol. 2019;14(1):61-7.
Halaby T, Naiemi N, Kluytmans J, Palen J, Grauls CM. Emergence of colistin resistance in Enterobacteriaceae after the introduction of selective digestive tract decontamination in an intensive care unit. Antimicrob Agents Chemother. 2013;57(7):3224-9.
Aminul P, Anwar S, Molla MMA, Miah MRA. Evaluation of antibiotic resistance patterns in clinical isolates of Klebsiella pneumoniae in Bangladesh. Biosaf Health. 2021;3(6):301-6.
Ghasemi Y, Archin T, Kargar M, Mohkam M. A simple multiplex PCR for assessing prevalence of extended-spectrum β-lactamases producing Klebsiella pneumoniae in Intensive Care Units of a referral hospital in Shiraz, Iran. Asian Pac J Trop Med. 2013;6(9):703-8.
Tamma PD, Han JH, Rock C, Harris AD, Lautenbach E, Hsu AJ, et al. Carbapenem therapy is associated with improved survival compared with piperacillin-tazobactam for patients with extended-spectrum β-lactamase bacteremia. Clin Infect Dis. 2015;60(9):1319-25.
Singh N, Pattnaik D, Neogi DK, Jena J, Mallick B. Prevalence of ESBL in Escherichia coli Isolates Among ICU Patients in a Tertiary Care Hospital. J Clin Diagn Res. 2016;10(9):19-22.