Extended-Spectrum-Beta-Lactamase (ESBL) production among Escherichia coli and Klebsiella species in Kumasi, Ghana.

Abstract

In recent times Enterobacteriaceae including Escherichia coli and Klebsiella spp., isolated in Kumasi at the Komfo Anokye Teaching Hospital (KATH) have shown significant resistance to 2^nd and 3^rd generation cephalosporins. Microbial resistance to these antimicrobials if due to the production of Extended Spectrum-Beta-Lactamases (ESBLs) may also indicate resistance to the aminoglycosides and other antibiotics. A total of 300 non-selected, non-duplicate isolates were collected and ESBL production was phenotypically determined using the Combined Disc Method. 149 (49.67%) of the isolates were ESBL- producing E. coli (44.37%) or Klebsiella spp. (55.03%). ESBL-producing organisms were more common among in-patients (54.60%) than they were among out-patients (46.27%). Meropenem emerged as the antimicrobial agent of choice for the treatment of serious infections associated with ESBL-producers on the basis of in vitro testing. The high level of ESBL production found in these Enterobacteriaceae with the resultant microbial resistance to the available cephalosporins and other agents may pose difficulties with the choice of therapeutic options for the treatment of severe infections. Efforts to prevent and/or control outbreaks of infections with ESBL-producing organisms must emphasize on the judicious use of all antibiotics.

Keywords: Extended Spectrum-Beta-Lactamases (ESBLs), Cephalosporins, Enterobacteriaceae.