Evaluation of effective antibiotics against extend-spectrum beta-lactamase (ESBLs) enzymes producing Enterobacteriaceae in outpatients referred to Nobel Laboratory, Isfahan ۲۰۱۷-۲۰۱۹

Background and Aim : Introduction: Extended-spectrum beta-lactamases enzymes (ESBLs) cause resistance to many beta-lactams whose prevalence among Enterobacteriaceae is a serious threat to the successful treatment of infections with these enzymes and limits effective antibiotics. The aim of this study was to evaluate the frequency of ESBLs enzymes in Enterobacteriaceae family bacteria in outpatients referred to Isfahan Nobel Laboratory during ۲۰۱۷-۲۰۱۹ and to introduce antibiotics effective on them.Methods : methods: After detection of Enterobacteriaceae family, ESBLs enzymes with initial resistance to ceftazidime and ceftriaxone discs were examined by confirmatory tests using clavulanic acid. On the other hand, in order to find the most effective antibiotics, antibiotic susceptibility testing was performed with ۱۴ different antibiotics.Results : Results: A total of ۵۸۰ strains of Escherichia coli, ۷۲ strains of Enterobacter, ۳۶۲ Klebsiella, ۲۲ strains of Serratia and ۳۵ strains of Citrobacter were isolated, with ESBL enzymes frequency of ۳۰, ۳۸, ۴۵, ۵۲ and ۵۶%, respectively. The most effective antibiotics in all ESBL-containing bacteria were imipenem, meropenem, fosfomycin, amikacin and nitrofurantoin.Conclusion : Discussion & Conclusion: The rate of ESBL enzymes in outpatients was high, which is a cause for concern about their spread in the community. Citrobacter strains also had higher levels of these enzymes. Both antibiotics fosfomycin and nitrofurantoin are recommended as the best treatment options for these outpatient patients.

کلیدواژه ها:

beta-lactamase ، Enterobacteriaceae ، antibiotics ، resistance