Frequency Of Extended-spectrum Beta-lactamases Research Articles

Epidemiology and Sensitivity to Antibiotics of Enterobacteriaceae Producing Extended-Spectrum Beta-Lactamases (ESBL) in the Region of Nouakchott (Mauritania)

Introduction: Extended-spectrum beta-lactamases (ESBL) are a large heterogeneous family of bacterial enzymes discovered in 1980. They are induced either by plasmids or by mutation of the natural genome in the bacterium. Both mechanisms give affected bacteria the ability to hydrolyze a very wide variety of beta-lactams. (ESBL)-producing bacteria represent a major concern due to their epidemic spread and their multiresistance to antibiotics The purpose of this study was to: determine their frequency of ESBL, know their distribution according to sex, hospital department, assess their levels of resistance to antibiotics and educate clinicians on the rational prescription of antibiotics. Materials and Methods: This is a retrospective study which was carried out within the central laboratory of the National Hospital Center of Nouakchott (CHN) over two years. The antibiogram was carried out by the method of diffusion in agar medium or on the Vitek-2 automaton (Biomérieux®) The production of ESBLs has been demonstrated by looking for a synergy between clavulanic acid and third-generation cephalosporins according to the usual techniques. Results: Out of 650 species of Enterobacteriaceae, 18.46% produced ESBL, including 58% in hospitalized patients and 42% in outpatients. The ESBL resistance rate was high to quinolones, aminoglycosides (except amikacin) and cotrimoxazole, fosfomycin and carbapenems retain good activity. Discussion: ESBLs are increasingly incriminated in both community-acquired and nosocomial infections and represent a real public health problem. In fact, 42% of ESBL isolated during our study came from outpatient consultations. This dissemination of ESBL in the community is alarming and could be explained, in part, by the anarchic use of antibiotics, it has also been mentioned by several studies. Fosfomycin retains excellent efficacy against ESBL in our study with 90% sensitivity. The resistance of Enterobacteriaceae to carbapenems remained marginal with sensitivity rates of 98 to 100% , making them the best treatment against ESBL-producing Enterobacteriaceae. However, the misuse of these molecules has led to the emergence of resistance to these antibiotics, especially in certain enterobacteriaceae. Conclusion: Considering the results of our study and the data from the literature, it clearly appears that ESBLs are taking an increasingly important place among multiresistant bacteria. The increase in resistance should be compared with the increase in antibiotic consumption. These trends are problematic because they promote not only the emergence and spread of ESBL enterobacteriaceae, but also those of carbapenemase-producing enterobacteriaceae (CPE). Faced with this worrying situation and given the increased risk of therapeutic impasse caused by these multi-resistant strains; very early detection of ESBL germ infections, isolation of patients carrying a transmissible infection and rational use of antibiotics should be carried out.

Activity of Fosfomycin against the Spectrum of Uropathogens Causing Cystitis

Background: Urinary tract infections (UTIs) are the most frequent bacterial infections commonly seen in females. A high degree of antimicrobial resistance in uropathogens has challenged the use of therapeutic agents. Fosfomycin, which is an old antibiotic with distinctive characteristics, seems to be a promising novel therapeutic agent with a good bactericidal activity towards multi-drug resistant (MDR) uropathogens. Objective: The main objective of the study is to evaluate the antibacterial activity of fosfomycin among uropathogens causing cystitis. Methods: The study was carried out between 2017-2018. A total of 2060 UTI suspects from outpatient departments (OPDs) and inpatient departments (IPDs) were screened. Out of 2060 screened patients, 1658 were IPD patients, and 402 were OPD patients. The patient’s midstream urine samples were collected aseptically and processed according to standard protocols. The frequency of extendedspectrum- beta lactamases (ESBLs) producer and carbapenem resistance were estimated, respectively. Cultures with significant growth of uropathogens were identified, and minimum inhibitory concentration (MIC) to fosfomycin was determined by agar dilution (AD) and by E-test methods. Results: 184 out of 2060 (8.9%) urine samples showed significant growth of uropathogens. Uropathogenic Escherichia coli (UPEC) (64%, 118/184) was found to be the most isolated uropathogen. Among these Gram-negative uropathogens, 80% were ESBLs producers, 43.2% were carbapenemresistant, and 78% isolates were found to be MDR. The fosfomycin susceptibility for UPEC was 95% by the AD method. Conclusions: This study suggests that fosfomycin is reasonably effective and can be used in the treatment of MDR uropathogens along with uncomplicated UTIs.

Extended spectrum Beta lactamases (ESBLs): Preference for age and gender; a hospital-based study

Background: Antibiotic resistance is a challenge to treat. Extended Spectrum Beta Lactamases (ESBL) is one of the phenomenon by which the uropathogen express resistance to the commonly used antibiotic. Objectives: To determine the frequency of ESBL in uro-pathogens and ESBL preference for age and gender. Methods: This cross sectional study was conducted in Qazi Hussain Ahmed Medical Complex Nowshera from 1stMar 2019 to 31st Jan 2020. A total of 315 urine samples were received for Culture and sensitivity out of which 77 cases reported to be ESBL positive (24.44%).Relevant information’s were recorded in SPSS version 25. Results: A total of 77 cases with established ESBL phenomenon were studied. 40% were males and 60% females. The frequency of ESBL positive isolates was (24.44%). In 71(92%) cases of ESBL , Escherichia coli strain was reported, Klebsiella pneumonia in 5(6.5%) and Proteus mirabilis in 1.3% cases. The difference in Means +SD of age of the male gender (24.25years+9.6) was statistically significant with female gender(31.16years+14.49) (p-value 0.02). The probability of ESBL infections was 2.16 times higher in female gender (p-value: 0.01, OR:2.16). The sensitivity pattern of the ESBL producing E. coli was; Imipenem(IMP) 100%, Meropenem(Mem)100%, Piperacillin Tazobactam(TZP) 92%, Nitrofurantoin (F)-85% . While Imipenem & meropenem were drugs of choice for ESBL-Klebsiella pneumonia and ESBL -Proteus mirabilis. Conclusion: The frequency of ESBL isolates was 24.44%. Female gender reported more ESBL infection as compared to male gender. Escherichia coli ESBL was most common. The common sensitivity pattern to ESBL was: Imipenem(IMP) 100%, Meropenem(Mem)100% and Piperacillin Tazobactam 95%.

Occurrence of ESBLs in Clinical Isolates of Klebsiella Species and Comparative Analysis of Phenotypic Detection Methods

Aims:Drug resistance enzymes like beta-lactamases and Extended-Spectrum Beta- Lactamases (ESBLs) are mostly produced in the response of mutation and a few other factors. These enzymes are plasmid-mediated that can confer resistance against several β-lactam agents including cephalosporin and extended-spectrum cephalosporin. This study is conducted to determine the frequency of ESBL producing Klebsiella strains and to compare the phenotypic detection methods among various clinical samples collected from a commercial centralized Microbiology diagnostic laboratory.Materials and Methods:125 Klebsiella strains were collected for this study. After identification and susceptibility testing, the phenotypic characterization of ESBL producing K. pneumoniae (n=89) and K. oxytoca (n=36) species was performed by using the double disc synergy test and the combination disc test.Results:In our study, 80 (64%) Klebsiella isolates were found to be ESBL positive due to their ability to produce an extended zone of inhibition with combination disc whereas 45 (36%) isolates were ESBL negative with no extended zone of inhibition. The phenotypic findings obtained by using the combination disc method and double disc synergy method were re-confirmed by molecular methods. By comparing the phenotypic finding with the genotypic results, we identified 80 (64%) Klebsiella isolates as ESBL positive and 45 (36%) isolates as ESBL negative. These genotypic findings of the ESBL producing strains were similar to the results obtained from the combination disc method. It also confirmed that the double disc synergy test was unable to detect 47 ESBL producing klebsiella strains.Conclusion:For implementing strict infection control policy and to stop the spread of resistant strains, it is important to detect ESBL producing isolates more rapidly. A suitable antimicrobial therapy can be started timely with the early detection of resistance enzymes either phenotypically or genotypically. It has been proved that the combination disc test can be used more reliably and preferably as compared to the double disc synergy test for the detection of ESBL enzymes produced by Klebsiella strains.

Prevalence of Extended-Spectrum β-Lactamases in Multi-drug Resistant Pseudomonas aeruginosa from Diabetic Foot Patients.

Pseudomonas aeruginosa is one of the major pathogens associated with the acute tissue damage in patients having Diabetic Foot Ulcer (DFU). The treatment of such infections can be an uphill battle due to the serious resistance to all the mainstay antibiotics, owing to overzealous production of Extended-Spectrum Beta-Lactamases (ESBLs). Pakistan also has a high prevalence of diabetes and complications related to it, however genetic disposition of the pathogens remains underinvestigated. The main objective of the study was to determine the frequency of ESBLs in Multi-drug resistant P. aeruginosa from diabetic foot patients. The duration of the present study was one year and 100 patients having DFU were enrolled. All the pus samples were subjected to the bacterial culture, gram staining, catalase test, oxidase test and antimicrobial susceptibility pattern to various antibiotics for the confirmation of P. aeruginosa. Of 23 positive isolates of P. aeruginosa, 10 were ESBLs positive as detected by double disk diffusion test. The positive ESBL strain shows an increase of ≥5mm in the zone of inhibition of the combination discs in comparison to the alone ceftazidime disc. The ESBLs positive strains were also tested for TEM-1, SHV-1, PER-1, and VEB-1, where: (07/10) strains carried SHV-1, (05/10) strains were positive for TEM-1, while none of the isolates were PCR-positive for PER-1 and VEB-1. The findings of the current study show a difference in the pattern of ESBL genes compared to that of other such endeavors. The present study also warrants the PCR-based detection of the type of ESBL as a potential factor to consider in deciding the therapeutic strategy at any point during the treatment.

Frequency of Extended-Spectrum Beta-lactamases (ESBLs) in strains of Klebsiella and E. coli isolated from patients hospitalized in Yazd.

IntroductionFrequency of extended-spectrum beta-lactamases (ESBLs) and its variants may vary in different geographical areas, as reports indicate their spread in some certain communities. The aim of this study was to determine the frequency of ESBLs in strains of Klebsiella and E. coli, isolated from patients hospitalized in teaching hospitals of Yazd.MethodsThis cross-sectional study was carried out on samples including E. coli and Klebsiella strains collected from laboratories of Shahid Sadoughi and Shahid Rahnemoun hospitals in Yazd, Iran in the period of 2011–2012. The colonies which were positive in lactose Eosin methylene-blue (EMB) medium were identified by biochemical methods, and 270 strains of Klebsiella and E. coli were isolated. Collected data and information were analyzed using Fisher’s exact test and descriptive statistics such as mean in SPSS software, version 15, at a significant level of 0.05.ResultsIn this study, 270 samples were examined, including 152 samples of E. coli (56.3%) and 118 samples of Klebsiella pneumonia (43.7%). Among the 152 samples of E. coli, 45 strains (30%) were producers of ESBLs. In addition, among the 118 samples of Klebsiella pneumonia, 44 strains (37.3%) were producers of ESBLs. E. coli strains showed the most resistance to Cefotaxime (100%), Ceftazidime (97.7%), and Cefepime (75.5%) respectively and Klebsiella strains showed the most resistance to Cefotaxime (100%), Ceftazidime (100%) and Cefepime (79.5%), respectively.ConclusionFrequency of ESBLs in Klebsiella strains was higher than E. coli strains. No significant relationship was found between frequency of ESBLs and age or gender. In addition, E. coli strains showed the highest sensitivity to Imipenem, Amoxicillin/clavulanate, and Ciprofloxacin, while the highest antibiotic sensitivity of Klebsiella strains was shown to be to Piperacillin, Imipenem, and Amoxicillin/clavulanate.

The erratic antibiotic susceptibility patterns of bacterial pathogens causing urinary tract infections.

Increasing trend of antibiotic resistance and expression of Extended Spectrum Beta Lactamases (ESBLs) are serious threats for public health as they render the treatment ineffective. Present study was designed to elucidate the antibiotic-susceptibility patterns of ESBL and non-ESBL producing E. coli and K. pneumoniae causing urinary tract infections so that the ineffective antibiotics could be removed from the line of treatment. The bacterial isolates obtained from the urine of patients visiting a tertiary health care facility were cultured for strain identification using API20E. Antimicrobial susceptibility and ESBL detection were done by Kirby-bauer diffusion technique. Almost 53.4 % isolates of E. coli and 24.5 % isolates of K. pneumoniae were found to be ESBL producers. The ESBL producing bacteria were found to be more resistant towards various antibiotics. The most effective drugs against E. coli ESBL isolates were imipenem (99.54 %), ampicillin-sulbactam (97.48 %), piperacillin-tazobactam (96.86 %), fosfomycin (94.51 %), amikacin (92.26 %) and nitrofurantoin (90.68 %). The most effective drugs against K. pneumoniae ESBL isolates were imipenem (97.62 %), piperacillin-tazobactam (95.35 %), ampicillin-sulbactam (90.48 %) and amikacin (88.37 %). The antibiotics having the highest resistance, particularly by the ESBL producers were amoxicillin clavulanic acid, sulphamethoxalzole/ trimethoprim, cefuroxime, cefpirome, ceftriaxone and ciprofloxacin. Most of the isolates showed multi drug resistance (MDR). High frequency of ESBL producing E. coli and K. pneumoniae were observed as compared to previous data. Penicillins, cephalosporins and some representatives of fluoroquinolones were least effective against the common UTIs and are recommended to be removed from the line of treatment.

Extended Spectrum Beta-lactamases: Definition, Classification and Epidemiology

Extended spectrum beta-lactamases (ESBLs) are defined as enzymes produced by certain bacteria that are able to hydrolyze extended spectrum cephalosporin. They are therefore effective against beta-lactam antibiotics such as ceftazidime, ceftriaxone, cefotaxime and oxyimino-monobactam. The objective of the current review is to provide a better understanding of ESBL and the epidemiology of ESBL producing organisms which are among those responsible for antibiotic resistant strains. Globally, ESBLs are considered to be problematic, particularly in hospitalized patients. There is an increasing frequency of ESBL in different parts of the world. The high risk patients are those contaminated with ESBL producer strains as it renders treatment to be ineffective in these patients. Thus, there an immediate needs to identify EBSL and formulate strategic policy initiatives to reduce their prevalence.

The Frequency of Extended-spectrum Beta-lactamases and Antibiotic Resistance Patterns in Escherichia coli Strains Isolated from Blood Cultures

The Frequency of Extended-spectrum Beta-lactamases and Antibiotic Resistance Patterns in Escherichia coli Strains Isolated from Blood Cultures

The Frequency of Extended-spectrum Beta-lactamases and In-vitro Antibiotic Resistance in Escherichia coli and Klebsiella pneumoniae Strains Isolated from Blood Cultures

The Frequency of Extended-spectrum Beta-lactamases and In-vitro Antibiotic Resistance in Escherichia coli and Klebsiella pneumoniae Strains Isolated from Blood Cultures

Scenario of Extended Spectrum Beta Lactamase (ESBL) producing Escherichia coli in a rural medical college of Himachal Pradesh

Extended Spectrum Beta Lactamases (ESBLs) are beta-lactamases that hydrolyze extended-spectrum cephalosporins. They confer resistance to all β-lactam antibiotics with the exception of carbapenems. ESBL-producing organisms may appear susceptible to some extended-spectrum cephalosporins in routine antibiotic susceptibility testing. The detection of ESBL’s in 175 clinical isolates of Escherichia coli was done by a screening test, followed by comparison between two confirmatory tests i.e. double disc synergy test (DDST) and the Disc on disc (DOD) test. ESBL production was detected by DDST in 45% and by DOD in 23% of cases. The antibiotic susceptibility pattern by Kirby Bauer technique showed that 54% isolates were resistant to all the six first line antibiotics. Maximum drug resistance with ampicillin and no resistance with meropenem was seen. The results show that there is a high frequency of ESBL producing E.coli in our hospital . We recommend that an appropriate antibiotic policy should be framed in every hospital to check for indiscriminate use of drugs and that ESBL detection by DDST should be mandatory for every laboratory as it a easy and convenient way to detect drug resistance.

Survey frequency of extended-spectrum beta-lactamases (ESBLs) in Escherichia coli and Klebsiella pneumoniae strains isolated from urinary tract infection in Iran

Extended-spectrum beta-lactamases (ESBLs) are defined as β-lactamase capable of hydrolyzing third generation cephalosporin's and inhibited by β-lactamase inhibitor. Urinary tract infection (UTI) is a one of the most prevalent infection in worldwide and is the second most common infection. Most of UTI are due to Escherichia coli. Antibiotic resistance in ESBLs strains is one of the emerging health related problem in the world nowadays. The present study was performed at Tow Tertiary Care Hospitals in Isfahan, Iran during a 14 month period (7th June, 2008 to 6th July, 2010). Standard microbiological methods were performed. In order to validate the ESBLs producing strains, the ceftazidim, ceftazidim clavulanic acid, cefotaxim, cefotaxim clavulanic acid (according to CLSI, 2010) were used by disk diffusion method. Results from 91 samples showed that the frequency of E. coli and Klebsiella pneumoniae strains was 84/6 and 15/4% respectively, while the Frequency of ESBLs in E. coli and K. pneumoniae strains was obtained in 27 samples as 35/06% and 5 samples as 35/71%), respectively. According to result, there is high prevalence of ESBLs in E. coli and K. pneumoniae because the third generation cephalosporins are usually in the first line against too many severe infections. Justifiable use of this method will be an effective means of controlling and decreasing spread of ESBLs strains.

Qnr Prevalence in Extended Spectrum Beta-lactamases (ESBLs) and None-ESBLs Producing Escherichia coli Isolated from Urinary Tract Infections in Central of Iran.

Extensive use of quinolones has been associated with raising level of resistance. In the current, we focused on assessing the prevalence of Escherichia coli resistance to quinolones and frequency of qnrA, qnrB and qnrS in non ESBLs (extended spectrum beta-lactamases) and ESBLs producing E. coli with blaSHV and blaTEM. One hundred and fifty E. coli isolates were identified during Mar. 2007 to Apr. 2008 in Milad () hospital. They were tested for ESBLs production as well as quinolone resistance. PCR was performed for detection of blaSHV and blaTEM as well as qnrA, B and S. Of 150 isolates, forty-two (28%) ESBLs producing and one hundred and eight (72%) non-ESBLs producing E. coli were identified. 64.2% (n= 24) of E. coli producing ESBLs and 4.62% (n= 5) of non-ESBLs E. coli were resistance to ciprofloxacin. 95.2% (n= 40) and 26.1% (n= 11) of the isolates harbored blaTEM and blaSHV, respectively. 23.8% (n= 10) had both genes. 37.5% (n= 9) and 20.8% (n= 4) of ESBLs producing E. coli were positive for qnrA and qnrB respectively. qnrS was not identified in any isolate. Our study showed high frequency of ESBLs producing E. coli as well as quinolone resistance genes (qnrA, qnrB) in Milad hospital.

Enterobactérias produtoras de ESBL em Passo Fundo, estado do Rio Grande do Sul, Brasil

The main emerging resistance mechanism relating to Enterobacteriaceae is represented by production of extended spectrum beta-lactamases (ESBLs). These enzymes have the capacity to hydrolyze broad-spectrum cephalosporins and are greatly used for antimicrobial chemotherapy on enterobacterial infections. Although resistance to these agents presents remarkable geographical variability, the resistance rates are high in many countries A retrospective observational cross-sectional descriptive study was developed to evaluate the frequency of ESBLs among Enterobacteriaceae strains obtained from Hospital São Vicente de Paulo, Brazil ESBL production was noted in 24.8% (n = 208/838) of the isolates evaluated. Isolates of Escherichia coli represented 46.2% (n = 96/208) of the ESBL producers, followed by Enterobacter species (30.3%; n = 63/208). The sensitivity of these isolates to meropenem was 91.4% and to piperacillin/tazobactam, 67.4% The ESBL levels founded confirm the worldwide concern regarding this resistance mechanism.

-Lactam and aminoglycoside resistance rates and mechanisms among Pseudomonas aeruginosa in French general practice (community and private healthcare centres)

The aim of this study was to assess antibiotic resistance rates and mechanisms of beta-lactam and aminoglycoside resistance among isolates of Pseudomonas aeruginosa isolated in the extra-hospital setting (community and private healthcare centres). During a 4 month period, 226 non-repetitive strains of P. aeruginosa were collected from patients residing in private healthcare centres (73.5%) or at home (26.5%). Resistance rates were evaluated by MIC determination, and beta-lactam and aminoglycoside resistance was analysed by phenotypic tests, PCR amplification, cloning and sequencing. Among the ticarcillin-resistant strains (38.1%), 33.7% overexpressed their chromosomal cephalosporinase, 27.9% produced acquired penicillinases (21 PSE-1, 2 OXA-21 and 1 TEM-2), 4.7% produced extended-spectrum beta-lactamases (ESBLs) (3 TEM-21 and 1 SHV-2a) and 45.3% possessed a non-enzymatic resistance (NER). Thus, 88.4% had a single mechanism of resistance, whereas 11.6% cumulated several mechanisms. No carbapenemases were detected among the 6.6% imipenem-resistant strains. With regard to aminoglycosides, 23.0% of the strains exhibited an acquired resistance to gentamicin (GEN), tobramycin (TOB), amikacin (AMK) or netilmicin (NET). Enzymatic resistance was more frequent (71.2%) than NER (34.6%). Various aminoglycoside modifying enzymes were associated with overlapping phenotypes: 36.5% strains produced AAC(6')-I with either a serine (GEN-TOB-NET) or a leucine (TOB-NET-AMK) at position 119, or both variants (GEN-TOB-NET-AMK); 21.2% expressed ANT(2'')-I (GEN-TOB), 7.7% AAC(3)-II (GEN-TOB-NET), 5.8% AAC(3)-I (GEN) and 1.9% AAC(6')-II (GEN-TOB-NET-AMK) or AACA7 (TOB-NET-AMK). Antibiotic resistance rates in P. aeruginosa were globally similar in general practice as in French hospitals. This first analysis of resistance mechanisms showed an unexpectedly high frequency of ESBLs and an unusual distribution of aminoglycoside modifying enzymes.

Rapid 4 to 6 hour detection of extended-spectrum beta-lactamases in a routine laboratory

With the growing frequency of extended-spectrum beta-lactamases (ESBL) among Enterobacteriaceae, treatment of Gram-negative nosocomial infections requires rapid and reliable detection of this enzyme. Quicolor agar (QC agar) (Salubris Inc., Massachusetts, USA) is a novel chromogenic agar medium changing colour within 4 to 6 h due to the metabolic activity of growing bacteria. This study investigated the use of QC agar compared to Mueller Hinton agar (MH) for the detection of ESBL using disk diffusion and E-test. 100 Enterobacteriaceae isolated at Hacettepe University Hospital, of which 50 were predetermined to be ESBL positive and 50 as negative using the CLSI disk diffusion ESBL (phenotypic confirmatory test) criteria. For disk diffusion and E-test, cefotaxime+/-clavulanate (CT/CTL) and ceftazidime+/-clavulanate (TZ/TZL) were used, and for E-test, cefepime+/-clavulanate (PM/PML) was also used. QC agar rapid ESBL results for all strains were in agreement with the standard overnight procedure. All 50 ESBL positives were detected by both methods. For the 50 ESBL negatives, QC agar rapid results from E-test and disk diffusion were in complete accordance with the overnight MH results. Moreover, E-test detected 8 additional ESBL positive strains that disk diffusion missed. For disk diffusion, CT/CTL alone detected all 50 ESBL positives while TZ/TZL alone missed 5 ESBL positives. E-test CT/CTL alone confirmed all 50 ESBL positives and identified 4 additional ESBL-positive strains. When used together, E-test CT/CTL, TZ/TZL and PM/PML identified a total of 58 ESBL positives among the 100 strains tested. QC agar can be used for rapid and reliable ESBL detection within 4 to 6 h, using disk diffusion and E-test ESBL reagents. This rapid method should be further validated using genotype characterized ESBL and other beta-lactamase positive strains.

Occurrence of extended-spectrum beta-lactamases in Enterobacteriaceae isolated from hospitalized patients in Curitiba, southern Brazil

Production of extended-spectrum beta-lactamases (ESBL) by enterobacteria is an important resistance mechanism against antimicrobial beta-lactamics. We tested 498 bacterial strains isolated from two tertiary-care teaching hospitals for ESBL production, using screening breakpoints for aztreonam and third generation cephalosporins, according to CLSI recommendations. Among these isolates, 155 were positive for the ESBL screening test, and 121 (78%) were confirmed by the clavulanic acid combination disk method. We found a high frequency of ESBL (24%) among Enterobacteriaceae, with a frequency of 57.4% for Klebsiella pneumoniae, 21.4% for Klebsiella oxytoca, and 7.2% for E. coli. In other members of Enterobacteriaceae, non-Klebsiella and non-E. coli, the prevalence was 21.6%. Ceftriaxone and cefotaxime showed a higher sensitivity in the screening test (99.2%) when compared to ceftazidime, aztreonam and cefpodoxime. However, cefotaxime/cefotaxime plus clavulanic acid showed a higher sensitivity in the confirmatory test (96.7%).