Extended-spectrum β-lactamase (ESBL) in Omani Children Study of prevalence, risk factors and clinical outcomes at Sultan Qaboos University Hospital, Sultanate of Oman
Journal Title: Sultan Qaboos University Medical Journal - Year 2008, Vol 8, Issue 2
Abstract
Antimicrobial resistance is a growing problem worldwide, which imposes difficulties in the selection of appropriate empirical antimicrobial therapy. Tis study evaluated extended-spectrum β-lactamase (ESBL) isolates in 2005 in Te Department of Child Health at Sultan Qaboos University Hospital (SQUH), Oman. Methods: During the 2 month period from January 2005 to December 2005, ESBL isolates from paediatrics inpatients were identified and analysed. Risk factors for the patients who grew ESBLs were analysed. Results: 3.3% of E. coli and 6.6% of Klebsiella pneumoniae isolated were ESBL producers. Most of the ESBLs were from urine (46.2%) and blood (42.6%). Te main risk factors for ESBL in these children were previous exposure to antimicrobials (00%), prolonged hospital stay, severe illness (92.3%) and female gender (84.6%). Sensitivity of 00% was observed to carbapenems whereas 92% of the isolates were susceptible to amikacin. Te oximino-cephalosporins were 00% resistant. Klebsiella pneumoniae were 00% resistant to piperacillin-tazobactam and nitrofurantoin. E. coli was 00% resistant to trimethoprim-sulfamethoxazole and ciprofloxacin. No resistance was recorded for the following combinations: amikacin plus piperacillin-tazobactam, amikacin plus nitrofurantoin and gentamicin plus nitrofurantoin. Conclusion: ESBL-producing organisms are becoming a major problem in Omani children. Exposure to antimicrobials and long admissions are modifiable risk factors that should be targeted for better control. Carbapenems are the most sensitive and reliable treatment options for infections caused by ESBLs. Amikacin plus piperacillin-tazobactam or nitrofurantoin are good alternatives.
Authors and Affiliations
Zakariya Al Muharrmi| Departments of Microbiology & Immunology, Sultan Qaboos University Hospital, Muscat, Oman, Akbar M Rafay| Departments of Microbiology & Immunology, Sultan Qaboos University Hospital, Muscat, Oman, Abdullah Balkhair| Departments of Medicine, Sultan Qaboos University Hospital, Muscat, Oman, Salem Al-Tamemi| Departments of Child Health, Sultan Qaboos University Hospital, Muscat, Oman, Ali Al Mawali| Medical Student, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman, Hilal Al Sadiri| Medical Student, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman
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