The prevalence of extended-spectrum β-lactamases producing in Klebsiella pneumonia and Escherichia coli isolated from patients attending in Nan Hospital and Community Hospital in Nan province, Thailand (2004 – 2010)

Abstract

     This study aimed to determine the prevalence and antibiotic susceptibility patterns of extended-spectrum β-lactamases (ESBL)-producing K. pneumoniae and E. coli isolates collected from clinical specimens of patients attending Nan Hospital and Community Hospital in Nan province. Susceptibility testing was tested by using disk diffusion method. The double-disk synergy test and combination disk method were used to determine ESBL production. 9,559 Isolated of E. coli and 5,236 Isolated of K. pneumoniae were isolated during 2004 to 2010. ESBL-producing strains were found in 2,097 (21.9%) isolates of E. coli and 1,191 (22.7%) isolates of K. pneumoniae. ESBL-producing E. coli isolates were most commonly obtained from the urine (40.5%), followed by the wound-pus (22.7%), sputum (14.7%), blood (11.6%), and others (10.5%). The ESBL-producing K. pneumoniae isolates were most commonly obtained from the sputum (45.8%), followed by the urine (25.3%), wound-pus (18.3%), blood (8.6%) and others (2.1%). Nineteen and 23 percent of ESBL-producing E. coli and K. pneumoniae isolates, respectively occurred in adult of 71-80 year old, with almost 80 percent being adult of more than 30 years old. The prevalence of ESBLproducing E. coli isolates were 29.8 % in medicine wards and 27.8% in surgery wards. The ESBL-producing K. pneumoniae isolates were 29.6% in medicine wards, 25.5 % in surgery wards and 25.5% in Intensive Care Units (ICUs). The susceptibility of ESBL-producing E. coli and K. pneumoniae isolates to gentamicin, trimethoprim-sulfamethoxazole, chloramphenicol, norfl oxacin and tetracycline were less than 50 percent. More than 90 percent of ESBL-producing E. coli and K. pneumoniae isolates were susceptible to immipenem, meropenem, ertapenem and amikacin. The MDR of ESBL-producing E. coli and K. pneumoniae isolates were susceptible to immipenem, meropenem, and ertapenem more than 90%.