title: Prevalence of extended-spectrum beta-lactamase-producing Enterobacteriaceae in Bahrain.
abstract: OBJECTIVE
  To determine the occurrence of extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae in Bahrain.
  
  
  METHODS
  Retrospective analysis of records (January 2005-December 2006) at the Microbiology Laboratory of the Salmaniya Medical Complex, Bahrain which is the major national diagnostic laboratory.
  
  
  RESULTS
  Out of a total of 11,886 member of family of Enterobacteriaceae isolated, 2695 (22.6%) were ESBL producers. Majority of ESBL isolates were from inpatients (n=2363; 87.7%). Escherichia coli (52.2%) and Klebsiella pneumoniae (24.3%) were predominant and distributed comparatively in the hospital wards while Proteus spp. (17.6%) was predominant in medical wards. Urine was the major source (52.2%) with low occurrence in blood cultures. No carbapenem resistant isolates was identified but resistance to three classes of antibiotics was exhibited by >25% of the isolated ESBL strains. Nitrofurantoin resistance was identified in 38.2% of urinary isolates.
  
  
  CONCLUSIONS
  This is the first report from Bahrain and it indicates that the prevalence of ESBL-producing isolates is high. Carbapenems were the most active drug against the ESBL-producing isolates. We recommend strict infection control to prevent trafficking into the community.
authors.affiliation: Department of Microbiology, Immunology and Infectious Diseases, Arabian Gulf University, Manama, Bahrain. bindayna@agu.edu.bh
authors.forename: Khalid Mubarak
authors.initials: KM
authors.lastname: Bindayna
authors.forename: Abiola C
authors.initials: AC
authors.lastname: Senok
authors.forename: Afaf E
authors.initials: AE
authors.lastname: Jamsheer
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D001445:Bahrain / Q000453:epidemiology; D015780:Carbapenems / Q000494:pharmacology / Q000627:therapeutic use; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology*; D024881:Drug Resistance, Bacterial; D004755:Enterobacteriaceae / Q000187:drug effects / Q000201:enzymology / Q000302:isolation & purification*; D004756:Enterobacteriaceae Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology*; D005260:Female; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D014556:Urine / Q000382:microbiology; D018440:beta-Lactam Resistance; D001618:beta-Lactamases / Q000378:metabolism*
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems; D001618:beta-Lactamases