Alhussain Jabr Alzahrani, Naeem Akhtar.
Susceptibility patterns of extended spectrum ß-lactamase (ESBL)- producing Escherichia Coli and Klebsiella Pneumoniae isolated in a teaching hospital.
Pak J Med Res Jan ;44(2):64-7.

Objectives: To observe the antibiotic susceptibility pattern of ESBL-producing Escherichia coli and Klebsiella pneumoniae in clinical isolates. Methods: A retrospective analysis of antibiotic susceptibility of Escherichia coli and Klebsiella pneumoniae was carried out. Forty eight isolates of E. coli and 18 isolates of K. pneumoniae were screened as ESBL-producers against any one or more of the cefpodoxime, ceftazidime, cefotaxime, ceftriaxone and aztreonam by Dade Microscan. These ESBL-producing isolates were similarly tested for amoxycillin-clavulinic acid, ampicillin-sulbactam, piperacillin-tazobactam, ticaracillin-clavulinic acid, imipenem, meropenem, gentamicin, tobramycin, amikacin, ciprofloxacin, levofloxacin and trimethoprim-sulphametoxazole. Norfloxacin and nitofurantoin were tested only against isolates from urine samples. Results: Highest numbers of ESBL-producing E. coli were detected by cefpodoxime while ceftriaxone showed the least sensitivity. In some cases the isolates produced ESBL against only one of the antibiotics and in some cases more than one. ESBL-producing E. coli isolates showed highest susceptibilty to meropenem (95.8%) followed by amikacin (93.7%), and imipenem (91.7%). ESBL-producing K. pneumoniae showed highest suscptibilty to meropenem (94.4%) followed by gentamicin & piperacillin-tazocin (88.9%), and amikacin, ciprofloxacin & levofloxacin (83.3%). Susceptibility of both the organisms to other antibiotics was below 80%. Conclusions: ESBL-producing E. coli and K. pneumoniae had excellent susceptibility to meropenem and had variable susceptibility to aminoglycosides and fluoroquinolones but greatly reduced susceptibility to ß-lactam ß-lactamase-inhibitors combinations and trimethoprim-sulphametoxazole.

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