Prevalence and Molecular Characterization of Extended-Spectrum Beta-Lactamase (ESBL) Producing Enterobacteriaceae in Hospitalized Patients
ESBL-Producing Enterobacteriaceae in Hospitalized Patients
DOI:
https://doi.org/10.69750/dmls.03.04.0206Keywords:
Enterobacteriaceae, Extended-Spectrum Beta-Lactamases (ESBL), Drug Resistance, Microbial, Anti-Bacterial AgentsAbstract
Background: Extended-Spectrum Beta-Lactamase (ESBL) carbapenem-resistant Enterobacteriaceae (CRE) represent a substantial contributor to global antimicrobial resistance, resulting in morbidity, treatment failure, increased healthcare expenditures, and prolonged hospitalisations. The molecular characterisation of resistance determinants is crucial for understanding the propagation of resistance and the principles of antimicrobial stewardship.
Objective: To evaluate the prevalence, antibiotic resistance profiles, molecular attributes, and clinical risk factors associated with ESBL-Producing Enterobacteriaceae in hospitalised patients.
Methods: This investigation was prospective cross-sectional research carried out at the Department of Pathology at Sheikh Zayed Medical College/Hospital, Rahim Yar Khan, Pakistan, from January 2024 to December 2025. A total of 220 Enterobacteriaceae isolates were obtained from hospitalised patients by sequential sampling. Clinical specimens included urine, blood, respiratory secretions, wound swabs, and catheter-associated samples. The antimicrobial susceptibility testing was conducted using the Kirby–Bauer disc diffusion technique in accordance with CLSI recommendations. ESBL generation was phenotypically validated by the combined disc diffusion technique, whereas resistance genes were identified via multiplex PCR (blaCTX-M, blaTEM, and blaSHV).
Results: Extended-spectrum beta-lactamase (ESBL) synthesis was identified in 96 out of 220 isolates (43.6%). The primary ESBL-positive pathogens were Escherichia coli (52.1%) and Klebsiella pneumoniae (31.3%). The blaCTX-M gene was detected in 74.0% of isolates, followed by blaTEM at 48.9% and blaSHV at 35.4%. The multidrug resistance rate (MDR) among the isolates was 79.2 percent. Resistance was substantially correlated with a history of antibiotic use, duration of hospital stays, utilisation of urinary catheters, and admission to the ICU (p<0.05).
Conclusion: ESBL-producing Enterobacteriaceae are still very prevalent and multidrug resistant, highlighting the need for molecular surveillance and antimicrobial stewardship measures.
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