Extended-spectrum β-lactamase (ESBL) in Omani children

Study of prevalence, risk factors and clinical outcomes at Sultan Qaboos University Hospital, sultanate of Oman

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7 Citations (Scopus)

Abstract

Objectives: Antimicrobial resistance is a growing problem worldwide, which imposes difficulties in the selection of appropriate empirical antimicrobial therapy. This study evaluated extended-spectrum β-lactamase (ESBL) isolates in 2005 in The Department of Child Health at Sultan Qaboos University Hospital (SQUH), Oman. Methods: During the 12 month period from January 2005 to December 2005, ESBL isolates from paediatrics inpatients were identified and analysed. Risk factors for the patients who grew ESBLs were analysed. Results: 13.3% of E. coli and 16.6% of Klebsiella pneumoniae isolated were ESBL producers. Most of the ESBLs were from urine (46.2%) and blood (42.6%). The main risk factors for ESBL in these children were previous exposure to antimicrobials (100%), prolonged hospital stay, severe illness (92.3%) and female gender (84.6%). Sensitivity of 100% was observed to carbapenems whereas 92% of the isolates were susceptible to amikacin. The oximino-cephalosporins were 100% resistant. Klebsiella pneumoniae were 100% resistant to piperacillin-tazobactam and nitrofurantoin. E. coli was 100% resistant to trimethoprim-sulfamethoxazole and ciprofloxacin. No resistance was recorded for the following combinations: amikacin plus piperacillin-tazobactam, amikacin plus nitrofurantoin and gentamicin plus nitrofurantoin. Conclusion: ESBL-producing organisms are becoming a major problem in Omani children. Exposure to antimicrobials and long admissions are modifiable risk factors that should be targeted for better control. Carbapenems are the most sensitive and reliable treatment options for infections caused by ESBLs. Amikacin plus piperacillin-tazobactam or nitrofurantoin are good alternatives.

Original languageEnglish
Pages (from-to)171-177
Number of pages7
JournalSultan Qaboos University Medical Journal
Volume8
Issue number2
Publication statusPublished - Jul 1 2008

Fingerprint

Oman
Nitrofurantoin
Amikacin
Cross-Sectional Studies
Carbapenems
Klebsiella pneumoniae
Escherichia coli
Sulfamethoxazole Drug Combination Trimethoprim
Cephalosporins
Ciprofloxacin
Gentamicins
Inpatients
Length of Stay
Urine
Pediatrics
Sultan
Therapeutics
Infection
tazobactam drug combination piperacillin

Keywords

  • Anti-infective agents
  • Escherichia coli
  • Extended-spectrum β-lactamase
  • Klebsiella pneumonia
  • Oman
  • Risk factors

ASJC Scopus subject areas

  • Medicine(all)

Cite this

@article{0b40d00a56cf4a23a3842c11856bd190,
title = "Extended-spectrum β-lactamase (ESBL) in Omani children: Study of prevalence, risk factors and clinical outcomes at Sultan Qaboos University Hospital, sultanate of Oman",
abstract = "Objectives: Antimicrobial resistance is a growing problem worldwide, which imposes difficulties in the selection of appropriate empirical antimicrobial therapy. This study evaluated extended-spectrum β-lactamase (ESBL) isolates in 2005 in The Department of Child Health at Sultan Qaboos University Hospital (SQUH), Oman. Methods: During the 12 month period from January 2005 to December 2005, ESBL isolates from paediatrics inpatients were identified and analysed. Risk factors for the patients who grew ESBLs were analysed. Results: 13.3{\%} of E. coli and 16.6{\%} of Klebsiella pneumoniae isolated were ESBL producers. Most of the ESBLs were from urine (46.2{\%}) and blood (42.6{\%}). The main risk factors for ESBL in these children were previous exposure to antimicrobials (100{\%}), prolonged hospital stay, severe illness (92.3{\%}) and female gender (84.6{\%}). Sensitivity of 100{\%} was observed to carbapenems whereas 92{\%} of the isolates were susceptible to amikacin. The oximino-cephalosporins were 100{\%} resistant. Klebsiella pneumoniae were 100{\%} resistant to piperacillin-tazobactam and nitrofurantoin. E. coli was 100{\%} resistant to trimethoprim-sulfamethoxazole and ciprofloxacin. No resistance was recorded for the following combinations: amikacin plus piperacillin-tazobactam, amikacin plus nitrofurantoin and gentamicin plus nitrofurantoin. Conclusion: ESBL-producing organisms are becoming a major problem in Omani children. Exposure to antimicrobials and long admissions are modifiable risk factors that should be targeted for better control. Carbapenems are the most sensitive and reliable treatment options for infections caused by ESBLs. Amikacin plus piperacillin-tazobactam or nitrofurantoin are good alternatives.",
keywords = "Anti-infective agents, Escherichia coli, Extended-spectrum β-lactamase, Klebsiella pneumonia, Oman, Risk factors",
author = "Muharrmi, {Zakariya Al} and Rafay, {Akbar M.} and Abdullah Balkhair and Tamemi, {Salem Al} and Mawali, {Ali Al} and Sadiri, {Hilal Al}",
year = "2008",
month = "7",
day = "1",
language = "English",
volume = "8",
pages = "171--177",
journal = "Sultan Qaboos University Medical Journal",
issn = "2075-051X",
publisher = "Sultan Qaboos University",
number = "2",

}

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T1 - Extended-spectrum β-lactamase (ESBL) in Omani children

T2 - Study of prevalence, risk factors and clinical outcomes at Sultan Qaboos University Hospital, sultanate of Oman

AU - Muharrmi, Zakariya Al

AU - Rafay, Akbar M.

AU - Balkhair, Abdullah

AU - Tamemi, Salem Al

AU - Mawali, Ali Al

AU - Sadiri, Hilal Al

PY - 2008/7/1

Y1 - 2008/7/1

N2 - Objectives: Antimicrobial resistance is a growing problem worldwide, which imposes difficulties in the selection of appropriate empirical antimicrobial therapy. This study evaluated extended-spectrum β-lactamase (ESBL) isolates in 2005 in The Department of Child Health at Sultan Qaboos University Hospital (SQUH), Oman. Methods: During the 12 month period from January 2005 to December 2005, ESBL isolates from paediatrics inpatients were identified and analysed. Risk factors for the patients who grew ESBLs were analysed. Results: 13.3% of E. coli and 16.6% of Klebsiella pneumoniae isolated were ESBL producers. Most of the ESBLs were from urine (46.2%) and blood (42.6%). The main risk factors for ESBL in these children were previous exposure to antimicrobials (100%), prolonged hospital stay, severe illness (92.3%) and female gender (84.6%). Sensitivity of 100% was observed to carbapenems whereas 92% of the isolates were susceptible to amikacin. The oximino-cephalosporins were 100% resistant. Klebsiella pneumoniae were 100% resistant to piperacillin-tazobactam and nitrofurantoin. E. coli was 100% resistant to trimethoprim-sulfamethoxazole and ciprofloxacin. No resistance was recorded for the following combinations: amikacin plus piperacillin-tazobactam, amikacin plus nitrofurantoin and gentamicin plus nitrofurantoin. Conclusion: ESBL-producing organisms are becoming a major problem in Omani children. Exposure to antimicrobials and long admissions are modifiable risk factors that should be targeted for better control. Carbapenems are the most sensitive and reliable treatment options for infections caused by ESBLs. Amikacin plus piperacillin-tazobactam or nitrofurantoin are good alternatives.

AB - Objectives: Antimicrobial resistance is a growing problem worldwide, which imposes difficulties in the selection of appropriate empirical antimicrobial therapy. This study evaluated extended-spectrum β-lactamase (ESBL) isolates in 2005 in The Department of Child Health at Sultan Qaboos University Hospital (SQUH), Oman. Methods: During the 12 month period from January 2005 to December 2005, ESBL isolates from paediatrics inpatients were identified and analysed. Risk factors for the patients who grew ESBLs were analysed. Results: 13.3% of E. coli and 16.6% of Klebsiella pneumoniae isolated were ESBL producers. Most of the ESBLs were from urine (46.2%) and blood (42.6%). The main risk factors for ESBL in these children were previous exposure to antimicrobials (100%), prolonged hospital stay, severe illness (92.3%) and female gender (84.6%). Sensitivity of 100% was observed to carbapenems whereas 92% of the isolates were susceptible to amikacin. The oximino-cephalosporins were 100% resistant. Klebsiella pneumoniae were 100% resistant to piperacillin-tazobactam and nitrofurantoin. E. coli was 100% resistant to trimethoprim-sulfamethoxazole and ciprofloxacin. No resistance was recorded for the following combinations: amikacin plus piperacillin-tazobactam, amikacin plus nitrofurantoin and gentamicin plus nitrofurantoin. Conclusion: ESBL-producing organisms are becoming a major problem in Omani children. Exposure to antimicrobials and long admissions are modifiable risk factors that should be targeted for better control. Carbapenems are the most sensitive and reliable treatment options for infections caused by ESBLs. Amikacin plus piperacillin-tazobactam or nitrofurantoin are good alternatives.

KW - Anti-infective agents

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KW - Klebsiella pneumonia

KW - Oman

KW - Risk factors

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