Extended-Spectrum β-Lactamase-Producing Escherichia coli and Klebsiella Species in Pediatric Patients Visiting International Friendship Children's Hospital, Kathmandu, Nepal.

Introduction: Emergence and spread of antimicrobial resistance (AMR) is a global threat and significantly affects the treatment options for common infectious diseases. Inappropriate use of antibiotics, particularly third-generation cephalosporins, has contributed to the development of AMR. This stud...

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Publicado en:Infectious Diseases: Research & Treatment Vol. 13; pp. 1 - 8
Autores principales: Kayastha, Karuna, Dhungel, Binod, Karki, Shovana, Adhikari, Bipin, Banjara, Megha Raj, Rijal, Komal Raj, Ghimire, Prakash
Formato: research tables/charts Journal Article
Publicado: Sage Publications Inc. 2/27/2020
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 2/27/2020
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      pub: Sage Publications Inc.
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        atl: Extended-Spectrum β-Lactamase-Producing Escherichia coli and Klebsiella Species in Pediatric Patients Visiting International Friendship Children's Hospital, Kathmandu, Nepal.
      aug:
        au:
          Kayastha, Karuna
          Dhungel, Binod
          Karki, Shovana
          Adhikari, Bipin
          Banjara, Megha Raj
          Rijal, Komal Raj
          Ghimire, Prakash
        affil: Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Nepal
      sug:
        subj:
          beta-Lactamases
          Escherichia Coli Infections Epidemiology
          Klebsiella Infections Epidemiology
          Hospitals, Pediatric Nepal
          Escherichia Coli Infections Drug Therapy
          Klebsiella Infections Drug Therapy
          Human
          Prevalence
          Nepal
          Cross Sectional Studies
          Urinalysis
          Endotracheal Tubes
          Catheters
          Staining and Labeling Methods
          Blood Chemical Analysis
          Microbial Culture and Sensitivity Tests
          Cefotaxime Administration and Dosage
          Ceftazidime Administration and Dosage
          Escherichia Coli Analysis
          Klebsiella Analysis
          Ampicillin Administration and Dosage
          Ceftriaxone Administration and Dosage
          Imipenem Administration and Dosage
          Nitrofurantoin Administration and Dosage
          Penicillins Administration and Dosage
          Antibiotics, Combined Administration and Dosage
          Amikacin Administration and Dosage
          Drug Resistance, Multiple
      ab: Introduction: Emergence and spread of antimicrobial resistance (AMR) is a global threat and significantly affects the treatment options for common infectious diseases. Inappropriate use of antibiotics, particularly third-generation cephalosporins, has contributed to the development of AMR. This study aims to determine the prevalence of extended-spectrum β-lactamase (ESBL) production in Escherichia coli and Klebsiella species isolated from various clinical samples. Methods: This cross-sectional study was conducted at International Friendship Children's Hospital, Kathmandu, Nepal, from August 2017 to January 2018. A total of 1443 samples that included urine, pus, wound swab, endotracheal tip, catheter tip, and blood were collected from pediatric patients below 15 years and processed by standard microbiological methods. Following sufficient incubation, isolates were identified by colony morphology, gram staining, and necessary biochemical tests. Identified bacterial isolates were then tested for antibiotic susceptibility test by modified Kirby-Bauer disk diffusion method and were subjected to ESBL screening by using 30 µg cefotaxime and ceftazidime. The ESBL production was confirmed by combination disk method. Results: From a total of 103 nonduplicated clinical isolates, E. coli (n = 79), Klebsiella pneumoniae (n = 18), and Klebsiella oxytoca (n = 6) were isolated from different clinical specimens. Of which, 64 (62.1%) exhibited multidrug resistance, and 29 (28.2%) were ESBL producers. All ESBL-producing isolates were resistant toward ampicillin, cefotaxime, ceftriaxone, and ceftazidime. Most ESBL producers were susceptible toward imipenem (89.7%; 26/29), nitrofurantoin (82.8%; 24/29), piperacillin/tazobactam (79.3%; 23/29), and amikacin (72.4%; 21/29). Conclusions: A high prevalence of multidrug-resistant ESBL organisms was found in this study among pediatric patients. Treatment based on their routine identification and susceptibility to specific antibiotics is critical to halt the spread of AMR and ESBL.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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