High prevalence of extended spectrum β-Lactamase producing Enterobacterales isolated from major hospitals in Gaza strip.

BACKGROUND

Extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-PE) is a major public health problem in hospitals and the community. This study aims to investigate the prevalence of ESBL production among clinical isolates of Enterobacterales from five major hospitals in Gaza, and to determine the genes encoding the ESBL phenotype.

METHODS

A total of 250 Enterobacterales isolates were collected from five different hospitals in Gaza Strip, including Al-Shifa, Al-Aqsa, Al-Nasser, Indonesia and Naser hospital. Antimicrobial susceptibility test was performed on Muller-Hinton agar using Kirby-Bauer method according to CLSI. ESBL was detected using double-disk synergy methods. Molecular characteristics of the isolates that produced ESBL were investigated by multiplex PCR targeting the SHV, TEM, and CTX-M genes.

RESULTS

The overall prevalence of ESBL was 60%. ICU wards had the highest rate of ESBL-producing isolates (69.2%). K. pneumoniae was found to highest ESBL producer (67.5%). Of the 150 isolates that were identified as ESBL producers, 87% had at least one of the three ESBL genes and 45 (30%) of them carried multiple beta-lactamase genes with blaCTX-M being the most common (71.3%). Meropenem and imipenem demonstrated the highest susceptibility rates (80.7%) against isolates of ESBL-PE .

CONCLUSIONS

The prevalence of ESBL-PE was critical. It is essential to screen Enterobacterales for ESBL-PE in order to provide proper therapy and to prevent or limit the emergence and dissemination of drug resistance.