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Deanship of Graduate Studies
Document Details
Document Type
:
Thesis
Document Title
:
EXTENDED SPECTRUM BETA LACTAMASE (ESBL) PRODUCING BACTERIA, EPIDEMIOLOGY, RISK GROUPS, RISK FACTORS, DIAGNOSTIC METHODS, AND ANTIMICROBIAL SUSCEPTIBILITY PROFILE
لبكتيريا المنتجة لإنزيم الاكستندد سبكترم بيتا لاكتاميز,المرضى الاكثر عرضة للبكتريا الحاملة لانزايم ,االعوامل المحفزة للانتاج الانزيم في البكتريا, طرق التشخيص، الحساسية للمضادات الجرثومية
Subject
:
Faculty of medicine
Document Language
:
Arabic
Abstract
:
Antimicrobial resistance constitutes a major public health issue threatening human society and challenging all levels of healthcare and economic resources. The emergence and spread of Extended-Spectrum Beta-Lactamase-producing microorganisms (ESBL-POs) jeopardizes the efficacy of antimicrobials from the β-lactam family, which represent a major therapeutic option for a range of infections globally. The issue of ESBL-POs is all the more serious that it is frequently associated with coresistance to other antimicrobial classes or to multidrug-resistance (MDR). This study aimed to estimate the prevalence and incidence of ESBL-POs and investigate the associated microbiological characteristics and antimicrobial-susceptibility patterns. Methods: A prospective study involving all cases of ESBL-POs among all bacteriological samples collected over one year (November 2015- November 2016) in the Clinical & Molecular Microbiology Laboratory at King Abdulaziz University Hospital, Jeddah. Detection of ESBL-POs and antimicrobial-susceptibility profiles were done using automated Vitek 2 system. Clinical data such as use of antibiotics in the past 6 months and use of invasive devices were analyzed as risk factors for MDR. Results: The prevalence of ESBL-POs was 5.4% (95% CI=4.7% – 6.2%) for an incidence=54 per 1,000 isolates-years. Distribution by species showed 70.0% Escherichia coli, 28.5% Klebsiella pneumoniae and 1.5% Proteus mirabilis. Antimicrobial susceptibility studies showed 86.5% resistance to ≥1 antimicrobial classes and 20% MDR, more among Klebsiella pneumoniae than Escherichia coli isolates. In univariate logistic regression, the presence of MDR was significantly predicted by age (OR=1.02; p=0.026) use of urinary catheter (OR=2.05; p=0.046) and number of devices used (OR=1.60; p=0.046); however, only age (OR=1.02; p=0.022) was significant in multivariate model. Conclusion: Despite low prevalence of ESBL- producer among Enterobacteriaceae in our institution, clinicians and microbiologists should maintain a high level of alertness and contribute in effective screening and adequate treatment of infections caused by ESBL-POs according to international guidelines and the local epidemiological picture. Keywords: Extended-Spectrum Beta-Lactamase; Multidrug-Resistant, Escherichia coli; Klebsiella pneumonie ; E-test; Combined Disk Diffusion test; Vitek-2 system ; King Abdulaziz University Hospital, antimicrobial-susceptibility test.
Supervisor
:
Dr. Maha Al-Alawi
Thesis Type
:
Master Thesis
Publishing Year
:
1439 AH
2018 AD
Co-Supervisor
:
Prof. Asif Ahmad Jiman-Fatani
Added Date
:
Wednesday, July 18, 2018
Researchers
Researcher Name (Arabic)
Researcher Name (English)
Researcher Type
Dr Grade
Email
دلال محمد الأشعري
AL-Ashari, Dalal Mohammed
Researcher
Master
Files
File Name
Type
Description
43604.pdf
pdf
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