Extended-spectrum â-lactamase (ESBL) in Omani children : study of prevalence, risk factors and clinical outcomes at Sultan Qaboos university hospital, Sultanate of Oman

Objectives : Antimicrobial resistance is a growing problem worldwide, which imposes difficulties in the selection of appropriate empirical antimicrobial therapy. This study evaluated extended-spectrum β-lactamase (ESBL) isolates in 2005 in The Department of Child Health at Sultan Qaboos University H...

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Bibliographic Details
Published in:Sultan Qaboos University medical journal 2008, Vol.8 (2), p.171-177
Main Authors: al-Muharrmi, Zakariyya, Rafi, Akbar M., Balkhair, Abd Allah, al-Tamimi, Salim, al-Mawali, Ali, al-Sudayri, Hilal
Format: Article
Language:ara ; eng
Subjects:
Anti-infective agents
Beta lactamases
Diseases
Escherichia coli
Klebsiella pneumoniae
Risk factors
الأدوية
الأمراض
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Summary:Objectives : Antimicrobial resistance is a growing problem worldwide, which imposes difficulties in the selection of appropriate empirical antimicrobial therapy. This study evaluated extended-spectrum β-lactamase (ESBL) isolates in 2005 in The Department of Child Health at Sultan Qaboos University Hospital (SQUH), Oman. Methods : During the 12 month period from January 2005 to December 2005, ESBL isolates from paediatrics inpatients were identified and analysed. Risk factors for the patients who grew ESBLs were analysed. Results : 13.3 % of E. coli and 16.6 % of Klebsiella pneumoniae isolated were ESBL producers. Most of the ESBLs were from urine (46.2 %) and blood (42.6 %). The main risk factors for ESBL in these children were previous exposure to antimicrobials (100 %), prolonged hospital stay, severe illness (92.3 %) and female gender (84.6 %). Sensitivity of 100 % was observed to carbapenems whereas 92 % of the isolates were susceptible to amikacin. The oximino-cephalosporins were 100 % resistant. Klebsiella pneumoniae were 100 % resistant to piperacillin-tazobactam and nitrofurantoin. E. coli was 100 % resistant to trimethoprim-sulfamethoxazole and ciprofloxacin. No resistance was recorded for the following combinations : amikacin plus piperacillin-tazobactam, amikacin plus nitrofurantoin and gentamicin plus nitrofurantoin. Conclusion : ESBL-producing organisms are becoming a major problem in Omani children. Exposure to antimicrobials and long admissions are modifiable risk factors that should be targeted for better control. Carbapenems are the most sensitive and reliable treatment options for infections caused by ESBLs. Amikacin plus piperacillin-tazobactam or nitrofurantoin are good alternatives. الهدف : مقاومة البكتريا مشكلة متنامية في العالم. و هذا يضع صعوبات في إختيار المضاد الحيوي المناسب، هذه الدراسة تهدف إلى تقييم البكتيريا التي تفرز البيتالاكتاميز ذي الطيف المديد (ESBL) في قسم الأطفال بمستشفى جامعة السلطان قابوس من شهر يناير إلى شهر ديسمبر 2005. الطريقة : خلال 12 شهرا تم تحديد و دراسة تلك البكتيريا عند الأطفال الراقدين في قسم الأطفال. تم تحليل عوامل الإختطار عند المرضى الذين أصيبوا بتلك البكتريا. النتائج (13.3 %) من الأشريشيا المعوية و (16.6 %) من الكليبسيلا الرئوية تفرز البيتالاكتاميز ذي الطيف المديد. غالبية هذه البكتريا (46.2 %) جاءت من البول، و من الدم (42.6 %). و أهم عوامل الإختطار التي أدت إلى الإصابة بهذه البكتيريا هو إستخدام المضادات الحيوية (100 %)، و كلا من الترقيد الطويل في المستشفى و المرض الشديد (92.3 %). و كون المريض أنثى (84.6 %
ISSN:2075-051X
2075-0528