Background: Extended-Spectrum Beta-Lactamase (ESBL)-producing Klebsiella pneumoniae and Escherichia coli infections significantly impact healthcare delivery and contribute to global antibiotic resistance. Thus, knowledge of their prevalence and risk factors is essential for quick and effective treatment, prevention, and management. In this study, we investigated the prevalence of ESBL production among clinical K. pneumoniae and E. coli isolates, determined their susceptibility profile, and identified risk factors associated with their infections in a tertiary care hospital. Materials and Methods: two hundred ninety-one non-duplicate isolates from diverse clinical samples were collected and matched with patients' biographical information. The isolates were identified by standard microbiological methods and their antimicrobial susceptibility was determined by the disk diffusion method. All isolates were screened for ESBL production. Risk factors such as age, sex, hospitalization, and source of infection were assessed for their association with ESBL infections. Multivariate logistic regression analysis was used to identify associated risk factors. Results: out of the 291 isolates collected, 152 (52.2%) were K. pneumoniae, while 139 (47.8%) were E. coli. Approximately 43.3% (n=126) of the isolates were ESBL producers, with 54% as K. pneumoniae and 46% as E. coli. The ESBL producers were predominantly isolated from blood samples (100%) and exhibited higher resistance rates to ampicillin (96.1%), streptomycin (95.4%), trimethoprim (93.8%), tetracycline (92.3%) and other antibiotics (>70%), except for cefoxitin (34.4%) and imipenem (12.4%), compared with the non-ESBL producers (p<0.05). Multivariate analysis indicated that patients with sepsis or hospitalized were more likely to acquire ESBL infections (p<0.05). Conclusions: this study reports a higher prevalence of ESBL-producing E. coli and K. pneumoniae than previously reported in our hospital. Antimicrobial stewardship programs and effective infection control practices could help manage this growing concern.
Akinde et al. (Mon,) studied this question.