title: Genotypes of ESBL producing Escherichia coli and Klebsiella pneumoniae in relation to resistance to antimicrobial drugs.
abstract: The aim of the study was to evaluate the association of drug resistance with β-lactamase gene types in ESBL positive E. coli and Klebsiella pneumoniae-Kp.
  
  
  METHODS
  A total of 251 ESBL-positive E. coli and Kp isolates obtained from urine, tracheal aspirate, wound swab and blood from patients hospitalised at the University Clinics in Skopje were detected using the ESBL set and automated Vitek 2 system. Vitek was also used for susceptibility testing (determination of MIC of 17 antimicrobial agents). Multiplex PCR was used to identify genes for different types of ESBLs in a 100 randomly selected, ESBL positive strains.
  
  
  RESULTS
  More of the 87 ESBL typeable isolates (61%) harbour two or more bla genes and the frequency of antibiotic resistance was high in these isolates, compared to those with a single gene. Isolates with ≥ 3 genes were highly resistant to beta-lactams and non-beta lactams used. The degree of resistance to 3 rd generation cephalosporins was also high in these isolates (MIC ≥ 64). More of the ESBL-positive isolates showed higher resistance to cefotaxime than to ceftazidime.
  
  
  CONCLUSIONS
  Identification of the genes is necessary for the surveillance of their transmission in hospitals. Surveillance of antibiotic resistance patterns are crucial to overcome the problems associated with ESBLs.
authors.affiliation: Institute of Microbiology and Parasitology, Medical Faculty, Ss. Cyril and Methodius University, Skopje, R. Macedonia.
authors.forename: Ana
authors.initials: A
authors.lastname: Kaftandzieva
authors.affiliation: Institute of Microbiology and Parasitology, Medical Faculty, Ss. Cyril and Methodius University, Skopje, R. Macedonia.
authors.forename: Elena
authors.initials: E
authors.lastname: Trajkovska-Dokic
authors.affiliation: Institute of Microbiology and Parasitology, Medical Faculty, Ss. Cyril and Methodius University, Skopje, R. Macedonia.
authors.forename: Vesna
authors.initials: V
authors.lastname: Kotevska
authors.affiliation: Institute of Microbiology and Parasitology, Medical Faculty, Ss. Cyril and Methodius University, Skopje, R. Macedonia.
authors.forename: Zaklina
authors.initials: Z
authors.lastname: Cekovska
authors.affiliation: Institute of Microbiology and Parasitology, Medical Faculty, Ss. Cyril and Methodius University, Skopje, R. Macedonia.
authors.forename: Gordana
authors.initials: G
authors.lastname: Jankoska
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D024881:Drug Resistance, Bacterial; D004926:Escherichia coli / Q000187:drug effects* / Q000201:enzymology; D005838:Genotype; D006801:Humans; D007711:Klebsiella pneumoniae / Q000187:drug effects* / Q000201:enzymology; D008826:Microbial Sensitivity Tests; D018440:beta-Lactam Resistance; D001618:beta-Lactamases / Q000235:genetics*
chemical_list: D000900:Anti-Bacterial Agents; D001618:beta-Lactamases