Faecal prevalence of extended-spectrum Beta-lactamase (ESBL)-producing coliforms in a geriatric population and among haematology patients

Malays J Pathol. 2005 Dec;27(2):75-81.

Abstract

Antimicrobial resistance to the extended-spectrum cephalosporins is increasingly reported worldwide. In the local setting, nosocomial infections with multi-resistant Gram-negative bacilli are not uncommon and are a growing concern. However, there is limited data on the carriage rates of such organisms in the local setting. In May 2001, a prospective study was carried out to determine the enteric carriage rates of ceftazidime-resistant Gram negative bacilli (CAZ-R GNB) among residents of nursing homes and from in-patients of the geriatric and adult haematology wards of University Malaya Medical Centre. Ceftazidime-resistant Gram-negative bacilli (CAZ-R GNB) were detected in 25 samples (30%), out of which 6 were from nursing home residents, 5 from geriatric in-patients and 14 from the haematology unit. A total of 28 CAZ-R GNB were isolated and Escherichia coli (10) and Klebsiella pneumoniae (7) were the predominant organisms. Resistance to ceftazidime in E. coli and Klebsiella was mediated by extended-spectrum beta-lactamases (ESBLs). Although the majority of the CAZ-R GNB were from patients in the haematology ward, the six nursing home residents with CAZ-R GNB were enteric carriers of ESBL-producing coliforms. Prior exposure to antibiotics was associated with carriage of ESBL organisms and to a lesser extent, the presence of urinary catheters.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Ceftazidime / therapeutic use
  • Drug Resistance
  • Enterobacteriaceae / enzymology
  • Enterobacteriaceae / isolation & purification*
  • Enterobacteriaceae Infections / complications
  • Enterobacteriaceae Infections / epidemiology*
  • Feces / microbiology*
  • Hematologic Diseases / complications
  • Hematologic Diseases / microbiology
  • Humans
  • Inpatients / statistics & numerical data
  • Nursing Homes / statistics & numerical data
  • Polymerase Chain Reaction
  • Polymorphism, Single-Stranded Conformational
  • Prevalence
  • beta-Lactam Resistance
  • beta-Lactamases / metabolism*

Substances

  • Anti-Bacterial Agents
  • Ceftazidime
  • beta-Lactamases