Extended-spectrum beta-lactamase(ESBL) in Omani Children Study ofprevalence, risk factors andclinical outcomes at Sultan Qaboos University Hospital, Sultanate of Oman

Antimicrobial resist ance is a growing pro blem worldwide, which imposes difficu lties in the selection ofappropriate em pirical anti microbial th erapy. this study evaluated extended-s pectrum beta- iactamase (esbl) isolates in 2005 in thedepartment of child healt h at sultan qaboos univers ity hos pita l (squh), oman. meth ods: dur ing the 12 month period fromjanuary 2005 to december 2005, esbl isolates from paediatri cs inpat ients were identified and analysed . risk factors for the patie ntswho grew esbls were analysed . results: 13.3% of e. coli and 16.6% of klebsiella pneumoniae isola ted were esi3l producers. most ofthe esbls were from ur ine (4 6 .2%) and bloo d (4 2.6%). the main risk factors for esbl in these ch ildren were previous exposur e toantimicrobials (100%), prolonged hospital stay, severe illness (92.3%) and female gende r (84.6%). sensitivity of 100% was observed tocarbape nems whereas 9 2% of the isolates were susceptible to arnikacin. the oxirnino-cephalosporins were 100% resis tant. klebsiellapne umoniae were 100% resistan t to pipe rac illin- tazobactam and nitrofurantoin . e. coli was 100% resist ant to tr imet hoprim -sulfarnethoxazoleand ciprofl oxacin . no resistance was recorded for the following combinations: ami kacin plus piperacillin-t azob actarn,am ikacin plus nit ro fur antoin and gen tamici n plus nitro fu ran toin. conclusion: esbl-produc ing orga nisms are becomi ng a majorpro blem in oma ni childr en . expos ure to anti microbials and lon g admissions are modifiable risk facto rs that should be tar geted forbetter contr ol. carbapenems are the most sensitive and reliable treatment op tion s fo r infec tions caused by esbls. amikacin pluspip erac illin- tazo bactam or nitrofurantoin are good altern atives.