Abstract
OBJECTIVE: To estimate the distribution of ESBL producing capacity among different Gram negative
isolates along with specimen and department wise prevalence in a tertiary care hospital.
METHODOLGY: This cross-sectional study was conducted at the Microbiology section of Pathology
Department, Allama Iqbal Medical College, Lahore, Pakistan, from August 2016 to January 2017. Total of
437 clinical samples were collected from different wards of Jinnah Hospital, Lahore. Sample was
cultured on Blood agar, MacConkey’s agar, chocolate agar, CLED agar. After the identification every
Gram negative isolate was further processed for the antibiotic susceptibility testing following Modified
Kirby Bauer disc diffusion method. ESBL detection was performed by the combination drugs disc
method using ceftriaxone + clavulanic acid (30/10 µg) in case of Enterobacteriacae, ceftazidime
+ clavulanic acid (30/10µg) in case of Pseudomonas species.
RESULTS: Among total 437 patients male and female were 61% and 39% respectively, overall 21.5%
(94/437) were ESBl producers. Distribution of ESBL producers was as followed Acinetobacter spp 22.3%
(31/139), Escherichia coli 37.5% (27/72), Klebsiella spp 31.9% (15/47), Pseudomonas aeruginosa 8.4%
(13/154) and Proteus spp 32.0% (8/25). Department wise ESBL positivity was as followed Surgical units
25.6% (32/125) Medical unit 31.9% (30/94), Burn centre 10% (8/80), ICU 20% (8/40) Surgical Allied 11.7%
(4/34), Medical Allied 6.2% (2/32), Neurology 36.3% (8/22), Gynaecology 28.5% (2/7) and Dermatology
33.3% (1/3).
CONCLUSION: High percentage of ESBL positivity seen in Escherichia coli and Proteus spp, among
departments neurology and medical unit is holding maximum positivity. High frequency of ESBL
producing Gram negative isolates strongly recommend its detection and management accordingly. It
can lead to treatment failures in Gram negative rods associated infections.
Ayesha Rafique, Farhan Rasheed, Muhammad Saeed , Sajjad Hassan, Syeda Fatima Nadeem, Ambereen Anwar Imran. (2019) Epidemiology of Extended Spectrum Beta Lactamase Producing Gram Negative Rods, Journal of Liaquat University of Medical and Health Sciences, Volume-18, Issue-2.
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