Detection of extended spectrum beta- lactamases and antibiogram profile of Klebsiella species

Objectives: 1). To determine the prevalence of ESBLs producing Klebsiella species. 2). To examine their antibiogram profile. 3). To evaluate the association between ESBLs production and antibiotics resistance in Klebsiella isolates. Materials and methods: This prospective study included 116 non repeated isolates of Klebsiella species 62 obtained from urine and 54 recovered from wounds. These bacterial isolates were reidentified and tested for antibiotic sensitivity against 19 selected antimicrobial agents. Also, these isolates were evaluated for extended spectrum beta lactamases (ESBLs) by double disk synergy test. Results: Extended spectrum beta lactamases were found to be produced by 16.4% of the total studied Klebsiella isolates. Amikacin showed the lowest resistance rate (27.6%), while the highest one was detected against cephalothin, penicillin, cloxacillin and ampicillin (98.3%). The statistical analysis between ESBLs production and antibiotics resistance revealed a significant association only with ceftriaxone (p<0.05), cefotaxime (p<0.001), cefixime (p<0.001), gentamicin (p<0.05) and nitrofurantoin (p<0.05). Moreover, it was found that the strains produced ESBLs showed a higher resistance to all the used antibiotics except for levofloxacin. Conclusions: This study highlights the emergence of ESBLs producing strains of Klebsiella, which endowed with extremely wide spectrum of antibiotics resistance including resistance to pencillins, cephalosporin, aminoglycosides and fluroqunilones. This increased resistance to antimicrobial agents may result in treatment failure.