Frequency and Sensitivity of Extended Spectrum Beta-Lactamase Positive Organisms in a Secondary and Tertiary Level Hospital Network in Dhaka
Background: Extended spectrum β-lactamase (ESBL) positive organisms are now a global health concern including in Bangladesh. These are associated with treatment failure, increased morbidity and mortality and increased health care costs. In this study, frequency of ESBL positive organisms in some hea...
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| Format: | Article |
| Language: | English |
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Enam Medical College, Dhaka
2015-05-01
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| Series: | Journal of Enam Medical College |
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| Online Access: | http://www.banglajol.info/index.php/JEMC/article/view/23377 |
| _version_ | 1818835462401294336 |
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| author | Shah Md Zahurul Haque Asna Shameem Akhter M Mushfequr Rahman Najib Mohammad MA Hafez |
| author_facet | Shah Md Zahurul Haque Asna Shameem Akhter M Mushfequr Rahman Najib Mohammad MA Hafez |
| author_sort | Shah Md Zahurul Haque Asna |
| collection | DOAJ |
| description | Background: Extended spectrum β-lactamase (ESBL) positive organisms are now a global health concern including in Bangladesh. These are associated with treatment failure, increased morbidity and mortality and increased health care costs. In this study, frequency of ESBL positive organisms in some health care centres in Dhaka city has been observed and their current status of antibiogram has also been observed.
Objective: To observe the current status of antibiogram of ESBL positive organisms.
Materials and Methods: This cross-sectional study was done in the Department of Microbiology, Bangladesh Institute of Health Sciences (BIHS) General Hospital, Dhaka, Bangladesh from March, 2012 to February, 2013. Only E. coli and Klebsiella spp. from pus and urine specimens were included in this study. Isolation, identification and antibiotic sensitivity of the organisms were done by standard procedures.
Results: Organisms (Escherichia coli and Klebsiella spp.) isolated from urine and pus collected from different sites of 472 subjects were studied. Predominant organisms were Escherichia coli (82.8%) and remaining 17.2% were Klebsiella spp. ESBL positive organisms were higher in Escherichia coli (54.5%) than in Klebsiella spp. (44.4%) and higher in pus (77.0%) than in urine (49.1%) isolates. Imipenem is the most effective drug for treating ESBL positive organisms followed by colistin, tigecycline and piperacillin/tazobactam.
Conclusion: Imipenem, colistin, tigecycline and piperacillin/tazobactam drugs should be kept reserved and used only when other effective drugs are not available so that emergence of resistance against these drugs is deferred. While reporting the culture and sensitivity tests, the ESBL positive organisms should be pointed out with comment like this – “The organisms are ESBL positive and resistant to penicillins, cephalosporins and monobactams”. |
| first_indexed | 2024-12-19T02:51:06Z |
| format | Article |
| id | doaj.art-25d7d785bf2240d1b05f751030bbe5ca |
| institution | Directory Open Access Journal |
| issn | 2227-6688 2304-9316 |
| language | English |
| last_indexed | 2024-12-19T02:51:06Z |
| publishDate | 2015-05-01 |
| publisher | Enam Medical College, Dhaka |
| record_format | Article |
| series | Journal of Enam Medical College |
| spelling | doaj.art-25d7d785bf2240d1b05f751030bbe5ca2022-12-21T20:38:38ZengEnam Medical College, DhakaJournal of Enam Medical College2227-66882304-93162015-05-0152808710.3329/jemc.v5i2.23377Frequency and Sensitivity of Extended Spectrum Beta-Lactamase Positive Organisms in a Secondary and Tertiary Level Hospital Network in DhakaShah Md Zahurul Haque Asna0Shameem Akhter1M Mushfequr Rahman2Najib Mohammad3MA Hafez4Professor, Department of Microbiology, Bangladesh University of Health Sciences (BUHS), Dhaka, Bangladesh Associate Professor, Department of Microbiology, Bangladesh University of Health Sciences (BUHS), Dhaka, Bangladesh Assistant Professor, Department of Microbiology, Bangladesh University of Health Sciences (BUHS), Dhaka, Bangladesh Associate Professor, Department of Medicine, Bangladesh Institute of Health Sciences (BIHS) General Hospital, Dhaka, Bangladesh Professor, Department of Epidemiology & Biostatistics, Bangladesh University of Health Sciences (BUHS), Dhaka, Bangladesh Background: Extended spectrum β-lactamase (ESBL) positive organisms are now a global health concern including in Bangladesh. These are associated with treatment failure, increased morbidity and mortality and increased health care costs. In this study, frequency of ESBL positive organisms in some health care centres in Dhaka city has been observed and their current status of antibiogram has also been observed. Objective: To observe the current status of antibiogram of ESBL positive organisms. Materials and Methods: This cross-sectional study was done in the Department of Microbiology, Bangladesh Institute of Health Sciences (BIHS) General Hospital, Dhaka, Bangladesh from March, 2012 to February, 2013. Only E. coli and Klebsiella spp. from pus and urine specimens were included in this study. Isolation, identification and antibiotic sensitivity of the organisms were done by standard procedures. Results: Organisms (Escherichia coli and Klebsiella spp.) isolated from urine and pus collected from different sites of 472 subjects were studied. Predominant organisms were Escherichia coli (82.8%) and remaining 17.2% were Klebsiella spp. ESBL positive organisms were higher in Escherichia coli (54.5%) than in Klebsiella spp. (44.4%) and higher in pus (77.0%) than in urine (49.1%) isolates. Imipenem is the most effective drug for treating ESBL positive organisms followed by colistin, tigecycline and piperacillin/tazobactam. Conclusion: Imipenem, colistin, tigecycline and piperacillin/tazobactam drugs should be kept reserved and used only when other effective drugs are not available so that emergence of resistance against these drugs is deferred. While reporting the culture and sensitivity tests, the ESBL positive organisms should be pointed out with comment like this – “The organisms are ESBL positive and resistant to penicillins, cephalosporins and monobactams”.http://www.banglajol.info/index.php/JEMC/article/view/23377ESBL; Drug resistance; Cephalosporins |
| spellingShingle | Shah Md Zahurul Haque Asna Shameem Akhter M Mushfequr Rahman Najib Mohammad MA Hafez Frequency and Sensitivity of Extended Spectrum Beta-Lactamase Positive Organisms in a Secondary and Tertiary Level Hospital Network in Dhaka Journal of Enam Medical College ESBL; Drug resistance; Cephalosporins |
| title | Frequency and Sensitivity of Extended Spectrum Beta-Lactamase Positive Organisms in a Secondary and Tertiary Level Hospital Network in Dhaka |
| title_full | Frequency and Sensitivity of Extended Spectrum Beta-Lactamase Positive Organisms in a Secondary and Tertiary Level Hospital Network in Dhaka |
| title_fullStr | Frequency and Sensitivity of Extended Spectrum Beta-Lactamase Positive Organisms in a Secondary and Tertiary Level Hospital Network in Dhaka |
| title_full_unstemmed | Frequency and Sensitivity of Extended Spectrum Beta-Lactamase Positive Organisms in a Secondary and Tertiary Level Hospital Network in Dhaka |
| title_short | Frequency and Sensitivity of Extended Spectrum Beta-Lactamase Positive Organisms in a Secondary and Tertiary Level Hospital Network in Dhaka |
| title_sort | frequency and sensitivity of extended spectrum beta lactamase positive organisms in a secondary and tertiary level hospital network in dhaka |
| topic | ESBL; Drug resistance; Cephalosporins |
| url | http://www.banglajol.info/index.php/JEMC/article/view/23377 |
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