Faecal prevalence of extended-spectrum Beta-lactamase (ESBL)-producing coliforms in a geriatric population and among haematology patients.
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.
Nurul Atifah
M A
MA
Departments of Medical Microbiology, University of Malaya.
Loo
H K C
HK
Subramaniam
G
G
Wong
E H
EH
Selvi
P
P
Ho
S E
SE
Kamarulzaman
A
A
Parasakthi
N
N
D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002442:Ceftazidime / Q000627:therapeutic use; D004351:Drug Resistance; D004755:Enterobacteriaceae / Q000201:enzymology / Q000302:isolation & purification*; D004756:Enterobacteriaceae Infections / Q000150:complications / Q000453:epidemiology*; D005243:Feces / Q000382:microbiology*; D006402:Hematologic Diseases / Q000150:complications / Q000382:microbiology; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D009735:Nursing Homes / Q000706:statistics & numerical data; D016133:Polymerase Chain Reaction; D018807:Polymorphism, Single-Stranded Conformational; D015995:Prevalence; D018440:beta-Lactam Resistance; D001618:beta-Lactamases / Q000378:metabolism*
D000900:Anti-Bacterial Agents; D002442:Ceftazidime; D001618:beta-Lactamases