title: Antimicrobial Susceptibility of Klebsiella pneumoniae and Escherichia coli with Extended-Spectrum β-lactamase associated Genes in Hospital Tengku Ampuan Afzan, Kuantan, Pahang.
abstract: BACKGROUND
  To assess antimicrobial susceptibility of extended-spectrum β-lactamase- (ESBL-) producing Klebsiella pneumoniae and Escherichia coli isolates from Hospital Tengku Ampuan Afzan (HTAA), as well as to identify ESBL genes.
  
  
  METHODS
  Non-duplicate K. pneumoniae and E. coli isolates were recovered from various clinical samples. Isolates were screened for antimicrobial resistance by disc diffusion method. Isolates resistant to oxyimino-cephalosporins were subjected to phenotypic ESBL production. Detection of resistance genes was then performed using primers specific for ESBL genes (bla CTX-M, bla SHV and bla TEM).
  
  
  RESULTS
  Piperacillin/tazobactam and carbapenems remained the active β-lactam antibiotic against K. pneumoniae and E. coli. ESBLs were detected among 35.5% (39/110) of K. pneumoniae and 18.8% (28/149) of E. coli isolates. CTX-M β-lactamase was detected in 90% of all ESBL-positive isolates, whereas bla SHV and bla TEM genes were found among 56% and 52% of them, respectively. Twenty-eight percent (28%) of the total ESBL-positive isolates harboured the three ESBL genes, while 50% carried two of the tested ESBL genes.
  
  
  CONCLUSIONS
  ESBLs encoded by at least one ESBL genes are frequently isolated among K. pneumoniae and E. coli in HTAA. The significant proportion rate of these resistant determinants is alarming, thus monitoring their transmission and dissemination is essential to control it at an early phase.
authors.affiliation: Department of Basic Medical Sciences, Kulliyyah of Medicine, International Islamic University Malaysia (IIUM), 25200 Kuantan Pahang, Malaysia.
authors.forename: Saleh
authors.initials: S
authors.lastname: Mahdi Yahya Mohsen
authors.affiliation: Department of Basic Medical Sciences, Kulliyyah of Medicine, International Islamic University Malaysia (IIUM), 25200 Kuantan Pahang, Malaysia.
authors.forename: Hairul Aini
authors.initials: HA
authors.lastname: Hamzah
authors.affiliation: Department of Basic Medical Sciences, Kulliyyah of Medicine, International Islamic University Malaysia (IIUM), 25200 Kuantan Pahang, Malaysia.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Muhammad Imad Al-Deen
authors.affiliation: Department of Pathology, Hospital Tengku Ampuan Afzan, 25100 Kuantan Pahang, Malaysia.
authors.forename: Roesnita
authors.initials: R
authors.lastname: Baharudin
keywords: Escherichia coli; Klebsiella pneumoniae; antimicrobial resistance; beta-Lactamases; hospital