Abstract
Background Extended-spectrum β-lactamase (ESBL)- and AmpC-β-lactamase (ESBL)- and AmpC-Enterobacteriaceae have recently emerged as a public threat in the treatment of nosocomial as well as community-acquired infections. Very little information is currently available about its existence in Nepal. We, therefore, aim to determine the prevalence of ESBL and AmpC-β-lactamase (ESBL)- and AmpC-Enterobacteriaceae have recently emerged as a public threat in the treatment of nosocomial as well as community-acquired infections. Very little information is currently available about its existence in Nepal. We, therefore, aim to determine the prevalence of ESBL and AmpC-Methods During a 6-month period (November 2014–April 2015), a total of 190 stool specimens from 190 participants were obtained from different population. Of the total 260 fecal isolates, 152 from outpatient department (OPD) and 108 from healthy volunteer were collected. Stool specimens were cultured and enterobacterial isolates were subjected to antimicrobial susceptibility tests according to the standard microbiologic guidelines. ESBL was screened using ceftazidime (CAZ, 30 μg) and cefotaxime (CTX, 30 μg) and cefotaxime (CTX, 30 β-lactamase (ESBL)- and AmpC-Results The prevalence of ESBL, AmpC-β-lactamase (ESBL)- and AmpC-β-lactamase (ESBL)- and AmpC-Enterobacteriaceae have recently emerged as a public threat in the treatment of nosocomial as well as community-acquired infections. Very little information is currently available about its existence in Nepal. We, therefore, aim to determine the prevalence of ESBL and AmpC-E. coli was 70.2% followed by K. pneumoniae (12.7%), and among AmpC-β-lactamase (ESBL)- and AmpC-E. coli was 70.2% followed by E. coli was 70.2% followed by K. pneumoniae (12.7%), and among AmpC-K. pneumoniae (12.7%), and among AmpC-C. freundii 2/7 (28.57%) were detected highest among AmpC-β-lactamase (ESBL)- and AmpC-Conclusion Our study revealed a high prevalence of ESBL- and AmpC-β-lactamase-producing enteric pathogen in Nepalese OPD and healthy population. The significant increase of these isolates and increased rate of drug resistance indicates a serious threat that stress the need to implement the surveillance system and a proper control measure so as to limit the spread of ESBL-producing Enterobacteriaceae (ESBL-PE) in both OPD as well as in community. Therefore, healthcare providers need to be aware that ESBL- and AmpC-β-lactamase-producing strains are not only circulating in hospital environments but also in the community and should be dealt with accordingly.β-lactamase (ESBL)- and AmpC-Enterobacteriaceae have recently emerged as a public threat in the treatment of nosocomial as well as community-acquired infections. Very little information is currently available about its existence in Nepal. We, therefore, aim to determine the prevalence of ESBL and AmpC-β-lactamase (ESBL)- and AmpC-
Highlights
extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae (ESBL-PE), especially E. coli and K. pneumonia, have recently emerged as a major public health threat [1, 2] and are associated with high mortality, increased length of hospital stay, and high cost [3,4,5]
A total of 190 fecal samples were studied from two population groups: 102 from outpatient department (OPD) visiting hospital from various parts of the country with the specimen representing gastrointestinal tract received for R/E + M/E which was requested by the physician during general health checkup; a total of 88 out of which 58 students from college and 30 community people of Sandhikharka Municipality of Arghakhanchi District by door-to-door sampling were randomly selected in the study
Our study revealed a high prevalence of ESBL- and AmpCβ-lactamase-producing Enterobacteriaceae in the GI tract of both OPD and healthy subjects. e most prevalent ESBL producer strain appeared to be E. coli followed by K. pneumoniae in OPD as well as in healthy population
Summary
ESBL-producing Enterobacteriaceae (ESBL-PE), especially E. coli and K. pneumonia, have recently emerged as a major public health threat [1, 2] and are associated with high mortality, increased length of hospital stay, and high cost [3,4,5]. Reports from the Western Pacific, Eastern Mediterranean, and Southeast Asia regions showed the highest carriage rates and the most alarming being the recent ascending trends [13,14,15] Despite these growing worrisome issues, the data regarding prevalence and resistance mechanism of ESBL-producing Enterobacteriaceae in hospital as well as community setting in Nepal are lacking. Erefore, the present study aimed to determine the carriage of ESBL-PE in healthy community as well as OPD participants and further to determine the drug resistance to ESBL-PE isolates. E prevalence of ESBL, AmpCβ-lactamases, and coproducer (ESBL + AmpC-β-lactamase) producing Enterobacteriaceae in OPD participants were 30.92%, 18.4%, and 13.81%, respectively, while 25%, 6.4%, and 1.8% in healthy population. Our study revealed a high prevalence of ESBL- and AmpC-β-lactamase-producing enteric pathogen in Nepalese OPD and healthy population. e significant increase of these isolates and increased rate of drug resistance indicates a Canadian Journal of Infectious Diseases and Medical Microbiology serious threat that stress the need to implement the surveillance system and a proper control measure so as to limit the spread of ESBL-producing Enterobacteriaceae (ESBL-PE) in both OPD as well as in community. erefore, healthcare providers need to be aware that ESBL- and AmpC-β-lactamase-producing strains are circulating in hospital environments and in the community and should be dealt with
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