Frequency and detection of extended spectrum betalactamase in escherichia coli and klebsiella pneumoniae: A study at lady reading hospital peshawar

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 including 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 & allied 24.6%( 109/283),medical and allied 21.4% (95/241),paediatrics 18.5%(82/203),obstetrics &gynaecology23.2% (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. © 2015,postgraduate medical institute. all rights reserved.