Prevalence of extended spectrum beta lactamases (ESBL) in clinical isolates from a teaching hospital in Peshawar, Pakistan

Infections caused by ESBL producing members of the enterobacteriaceae have rapidly increased all over the world. ESBL increase the possibility of failure of empiric antimicrobial regimens. The aim of this study was to determine the prevalence of ESBL in bacterial isolates and to look into the options for treating infections caused by these organisms. A total of 4,150 isolates of enterobacteriaceae were studied. ESBL producer isolates were 371 (8.94%) out of which 281 (75.7%) were recovered from admitted patients while 90 (24.3%) were recovered from outdoor patients. ESBL detection was carried out according to Clinical Laboratory and Standard Institute (CLSI) criteria. Majority of the ESBL producing isolates were obtained from urine 282 (76.0%), followed by swabs 69 (18.6%) fluids 12 (3.2%) blood 06 (1.7%) and sputum 02 (0.5%). The ESBL phenotype was detected in 322 (89.5%) of the isolates of E. coli, 20 (5.4%) of Klebsiella spp. 14 (3.8%) Enterobacter and 05 (1.3%) Citrobacter spp. Carbapenems was the drug of choice for serious infection with ESBL ‐ producing organisms in Peshawar. These should not be administered as empiric therapy, because their over use can result in significant resistance in future.