title: Faecal prevalence of extended-spectrum Beta-lactamase (ESBL)-producing coliforms in a geriatric population and among haematology patients.
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.
authors.affiliation: Departments of Medical Microbiology, University of Malaya.
authors.forename: M A
authors.initials: MA
authors.lastname: Nurul Atifah
authors.forename: H K C
authors.initials: HK
authors.lastname: Loo
authors.forename: G
authors.initials: G
authors.lastname: Subramaniam
authors.forename: E H
authors.initials: EH
authors.lastname: Wong
authors.forename: P
authors.initials: P
authors.lastname: Selvi
authors.forename: S E
authors.initials: SE
authors.lastname: Ho
authors.forename: A
authors.initials: A
authors.lastname: Kamarulzaman
authors.forename: N
authors.initials: N
authors.lastname: Parasakthi
mesh_terms: 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*
chemical_list: D000900:Anti-Bacterial Agents; D002442:Ceftazidime; D001618:beta-Lactamases