Rectal Colonization with Extended Spectrum β-Lactamase producing Enterobacteriacieae in Surgical Patients in a Tertiary Hospital in Calabar, Nigeria

Autor: U. E. Emanghe, Thomas U. Agan, Ubong Akpan, UE Usang, Ernest Afu Ochang, G. I. Ogban
Rok vydání: 2014
Předmět:
Zdroj: IOSR Journal of Dental and Medical Sciences. 13:47-53
ISSN: 2279-0853
2279-0861
DOI: 10.9790/0853-13134753
Popis: Aim: Extended spectrum β-lactamases are transferable plasmid mediated resistance mechanisms found mainly among Enterobacteriaceae which confer resistance to numerous β-lactam antibiotics. The aim of the study was to determine the rate of rectal colonization of surgical patients with Escherichia coli carrying extended spectrum β-lactamases. Subjects and methods: We collected and cultured rectal swabs from 192 surgical patients in the University of Calabar Teaching Hospital, Calabar, Nigeria. Escherichia coli isolates were identified and antibiotics susceptibility performed using Modified Kirby-Bauer disc diffusion technique. Isolates showing zones of inhibition to third generation cephalosporins below Clinical and Laboratory Standard Institute recommended break-points were screened for ESBL-production by the double-disk synergy method. Results: A total of 67.7%(130) of the patients received prophylactic antibiotics which was continued empirically for ≥5days after surgery. Ceftriaxone was the most empirically prescribed antibiotic used with metronidazole in 63.1%(82/130) and alone in 7.7%(10/130) of patients. Ceftriaxone resistance was observed in 39.6%(76/192) of the rectal E. coli isolates with 3.1%(6/192) showing intermediate susceptibility. Ceftazidime resistance was observed in 40.6%(78/192) with 4.2%(8/192) showing intermediate susceptibility. ESBL mediated resistance was observed in 27.1%(52/192) of isolates. ESBL positive isolates were more likely to be resistant to Gentamicin, Ciprofloxacin and Co-trimoxazole than negative isolates (P
Databáze: OpenAIRE
Externí odkaz: