Prevalence and risk factors of extended-spectrum β-lactamases producing Enterobacteriaceae in a general hospital in Saudi Arabia

Abstract

Objective: To estimate the prevalence and associated risk factors of extended-spectrum β-lactamase producing Enterobacte-riaceae (ESBL) in King Khaled General Hospital, Saudi Arabia. Methods: A twelve-month retrospective study for the presence of ESBL producing Enterobacteriaceae infection was performed by using the Microbiology and Infection Control Departments' database. For all the collected specimens, microbiologi-cal identification and antimicrobial sensitivity testing were done using MicroScan WalkAway system and then confirmed by API 20E and E-test respectively. Results: The prevalence of ESBL producing Enterobacteriaceae infection among studied patients was 22%. The most common types of infections were urinary tract infections representing 59.2%. Previous use of antibiotics, urinary catheter, mechanical ventilation, previous hospitalization, previous intensive care unit admission and nosocomial origin of infection were significant risk factors for acquiring infection. Amikacin had the highest activity against ESBL producing isolates, whereas 20% of isolates were resistant to carbapenems Conclusions: The study revealed that prevalence of ESBL producing Enterobacteriaceae infection was relatively high. Our findings suggest that invasive devices, the use of antibiotics, prolonged hospitalization especially in the intensive care unit increases the risk of acquiring such infections. A strict antibiotic policy should be addressed especially with observed emergence of carbapenem resistance. Continuous review of need to invasive devices and strict compliance with basic infection control measures are mandatory to limit the spread of ESBL Enterobacteriaceae.