Occurrence and antimicrobial susceptibility pattern of ESBL among Gram-negative bacteria isolated from burn unit of Al Shifa hospital in Gaza, Palestine

Abstract

AbstractBackground: Infection is an important cause of death in burns. The emergence of antimicrobial resistant pathogens like ESBL producers is leading to inappropriate/or treatment failure and increased morbidity and mortality.Objective: the purpose of this study was to determine the antimicrobial susceptibility pattern with the identification of Extended spectrum Beta-lactamase (ESBL) producers among pathogens isolated from burn patients at Al-Shifa burn unit in Gaza, Palestine.Methods: A total of 40 gram-negative bacterial isolates were obtained from burn wound patients at Al-Shifa Hospital burn unit from August 2012 to December 2012. Antibiotic susceptibility profiles were determined by the standard disc diffusion method according to CLSI guidelines. The ESBL detection was screened by using double disc diffusion method.Results: Pseudomonas aeruginosa was the predominant isolate 15 (37.5%) followed by Klebsiella pneumoniae 10 (25%), Escherichia coli 9 (22.5%), Enterobacter cloacae 4 (10%) and Acinetobacter baumannii 2 (5%). ESBL was detected in 37.5% of isolates. Most of ESBL-producing isolates were susceptible to meropenem and imipenem (80% and 73% respectively). However, ESBL producing isolates showed 100% resistance against cefotaxime, followed by ampicillin with 93.3% resistance. The resistance rate towards sulfamethoxazole/trimethoprim, tetracycline, cefepime, tobramycin and aztreonam was 80%, 73.3%, 66.7%, 60% and 60% respectively. A. baumannii isolates were resistance to all tested antibiotics.Conclusion: P. aeruginosa is the most common bacteria isolated from burn wound patients. The frequency of ESBL among gram-negative bacteria is high. Carbapenems including imipenem and meropenem remain the most effective treatment options against gram-negative producing ESBL isolated from Al-Shifa burn unit.