Extended-spectrum ?-lactamase production in Klebsiella pneumoniae and Escherichia coli at Jimma University Specialized Hospital, South-West, Ethiopia

Abstract

Background: Extended spectrum β-lactamases (ESBLs) have emerged as a major threat worldwide with limited treatment options. The prevalence of ESBL producing Escherichia coli and Klebsiella pneumoniae strains largely remain unknown inEthiopia. Objectives: The study was aimed to determine the occurrence of extended spectrum β-lactamase-producing E. coli and K. pneumoniae among inpatient and outpatient settings, their antimicrobial resistance profile and associated risk factors in Jimma University Specialized Hospital (JUSH). Methods: Laboratory based comparative cross-sectional study design was conducted from September 2011 to February 2012. Result: A total of 471 consecutive, non repetitive clinical specimens were collected among inpatients (n=314) and outpatients (n=157). Among these, 112 isolates of K. pneumoniae (n=27) and E. coli (n=85) were recovered. Overall prevalence of extended spectrum beta lactamase (ESBL) producers was 38.4% (n=43) of total isolates. Extended spectrum beta lactamases were found in 28.2% (n=24) of E. coli and 70.4 % (n=19) of K. pneumoniae . Extended spectrum beta lactamase producers mediated very high resistance to both beta-lactams and non-betalactams and they were significantly higher among isolates from in-patients (46.4%) than out-patients (14.3%). On multivariare analysis, treatment with third generation cephalosporin was identified as a sole risk factor for acquisition of ESBL enzyme. Conclusions : Our findings confirmed that infection due to extended spectrum beta lactamase -producing E. coli and K. pneumonia is prevalent in Jimma University Specialized Hospital (JUSH) and exposure to third generation cephalosporin was associated with these infections. Resistance of these isolates to antibiotics was also higher among inpatients.