Extended-Spectrum Beta-Lactamase-Producing E. Coli and Klebsiella Pneumoniae in Children at University Pediatric Clinic in Skopje

Abstract

Aim. The objectives of this study were to determine the prevalence and antibiotic susceptibility patterns of extended-spectrum β-lactamases (ESBL)-producing Escherichia coli and Klebsiella pneumoniae. Material and methods. E. coli and K. pneumoniae were obtained from all clinical samples of hospitalized children. Results. During one year period, 212 strains of E. coli and 103 strains of K. pneumoniae were isolated. Of these, the ESBL production was observed in 26 (11.8%) isolates of E. coli and 25 (24.3%) isolates of K. pneumoniae. ESBLproducing E. coli isolates were commonly recovered from the respiratory tract (21.4%) and urine (7.2%). ESBL-positive K. pneumoniae was commonly recovered from urine (38.5%) and respiratory tract (18.7%). ESBL-positive E. coli isolates were more susceptible to AMC (76%) and SXT (50%), than were the isolates of ESBLpositive K. pneumoniae (40% and 32%). Considering aminoglycosides, 92% of ESBL-positive E. coli and 60% of ESBL-positive K. pneumoniae were susceptible to amikacin vs. 23% and 40% of ESBL-positive E. coli and K. pneumoniae strains to gentamicin. ESBL-positive K. pneumoniae strains were more susceptible to ciprofloxacin (84%) than ESBL-positive strains of E. coli (38%). Cefepime shows the best in vitro activity of tested cephalosporins (58% for E. coli and 72% for K. pneumoniae). All isolates were susceptible to imipenem. Conclusion. ESBL-producing E. coli and K. pneumoniae are present in our hospital environment. It’s necessary and useful to perform screening and confirmatory tests for phenotypic detection of those organisms in a routine work. Most of ESBL-producers are resistant to many classes of antibiotic, resulting in limited treatment options. OPEN²ACCESS Introduction Bacterial antibiotic resistance has become a major clinical concern worldwide. Recently, the use of second and third generation cephalosporins has led to the selection of Gram-negative organisms resistan