Epidemiology of Infections Caused by ESBL-Producing Enterobacteriaceae and Antibiotic Resistance Profile of Strains Isolated at Meknes-Based Moulay Ismail Military Hospital: A Retrospective Study from January 2018 to December 2020

Abstract

Introduction: Infections caused by ESBL-producing Enterobacteriaceae (ESBL-PE) pose a major public health challenge. In addition to their widespread presence and growing resistance to several categories of antibiotics, the medical management of these bacteria becomes intricate, potentially resulting in a therapeutic impasse. Our study's goal is to examine the regional epidemiological characteristics of ESBL-PE infections and present a current assessment of their antibiotic resistance. Methods: The retrospective investigation undertaken at the bacteriology laboratory of the Meknes-based Moulay Ismail Military Hospital, covering a period of three years (January 2018 to March 2021), specifically examines the isolates of ESBL-PE. Results: Among the 2596 strains of Enterobacteriaceae described, 16.4% were found to produce ESBL, with E. coli being accountable for 63.6% of these strains. 85.1% of these ESBL-PE were isolated from urine samples. Surgical services were the largest source of these ESBL-PE (54.3%), followed by the emergency department (22%), medical services (14.5%), and intensive care unit (9.2%). The antibiotic resistance of these ESBL-PE has been studied and found to be high for gentamicin (63%), tobramycin (66%), cotrimoxazole (85%), and ciprofloxacin (91%). Only 7% exhibited good sensitivity to amikacin, 4% to imipenem, and 5% to fosfomycin. Conclusion: The advent of ESBL-PE in our institution is a big challenge. To limit the use of carbapenems and prevent the spread of strains causing carbapenemases, other kinds of antibiotics can be utilized. The partnership between clinicians and the bacteriology laboratory is vital for efficiently preventing and monitoring the spread of these multidrug-resistant bacteria.