title: Susceptibility pattern of extended spectrum ß-lactamase producing isolates in various clinical specimens.
abstract: OBJECTIVE
  To determine the susceptibility pattern of extended spectrum ß-lactamase (ESBL) producing Gram negative isolates from various clinical specimens.
  
  
  METHODS
  Descriptive study.
  
  
  METHODS
  Microbiology Department, Armed Forces Institue of Pathology, Rawalpindi, from January 2008 to January 2009.
  
  
  METHODS
  A total of 308 ESBL producing isolates from various clinical specimens sent to AFIP for culture and sensitivity were identified using standard microbiological techniques and tested for antimicrobial susceptibility. At the same time screening for ESBL production was also done. ESBL production was confirmed by combination disc synergy method. The susceptibility pattern of isolates was then recorded in frequency percentages.
  
  
  RESULTS
  Out of the 308 ESBL producing isolates more than 99% were susceptible to carbapenems, 84% to tazobactam/ piperacillin, 81% to sulbactam/cefoperazone, 12% to fluoroquinolones, 13% to cotrimoxazole, 59% to amikacin and 18% to gentamicin. Among the urinary isolates 49% were susceptible to Nitrofurontoin and only 5% to Pipemidic acid.
  
  
  CONCLUSIONS
  Antibiotic choices in case of ESBL producing isolates are limited and at present only carbapenems can be regarded as treatment of choice. As empirical agents, beta-lactam/beta lactamase inhibitor combinations should be used cautiously for serious infections. Fluoroquinolones showed very poor efficacy. Amikacin can be used alternatively in such cases. Nitrofurantoin is still a good oral agent for treating UTI.
authors.affiliation: Department of Microbiology, Armed Forces Institute of Pathology, Rawalpindi.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Roshan
authors.forename: Aamer
authors.initials: A
authors.lastname: Ikram
authors.forename: Irfan Ali
authors.initials: IA
authors.lastname: Mirza
authors.forename: Nasrullah
authors.initials: N
authors.lastname: Malik
authors.forename: Shahid Ahmad
authors.initials: SA
authors.lastname: Abbasi
authors.forename: Shehla Ambreen
authors.initials: SA
authors.lastname: Alizai
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D024901:Drug Resistance, Multiple, Bacterial / Q000187:drug effects*; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D018570:Risk Assessment; D055815:Young Adult; D018440:beta-Lactam Resistance; D001618:beta-Lactamases / Q000096:biosynthesis*
chemical_list: D000900:Anti-Bacterial Agents; D001618:beta-Lactamases