Co-occurrence of Extended-Spectrum Beta-Lactamases in Isolated Enterobacter spp. From Patients Specimens

Abstract

Background: Clinical significance of Extended-Spectrum Beta-Lactamases (ESBLs) production in Enterobacter spp. has not well been established. Objectives: This study was conducted to investigate the prevalence of ESBLs produced by Enterobacter spp. in clinical isolates. Materials and Methods: This descriptive cross-sectional study was performed during May 2010 to April 2012 in the city of Sanandaj, Kurdistan province, Iran. We did not include and directly contact the patient population, yet had access to two thousand patient specimens (urine, wound, respiratory tube, blood, cerebrospinal fluid and stool), which were collected from patients that had referred to various departments of two government hospitals of Toohid and Besat. As a result, 118 Enterobacter spp. isolates were identified and considered. The Clinical and laboratory standard institute (CLSI) Combined Disk Test (CDT) and polymerase chain reaction (PCR) were applied for detecting Enterobacter spp. Data were analyzed using the SPSS 11.5 software, Chi-square (x(2)) test and a Kappa coefficient (kappa) (P < 0.05). Results: Out of 118 Enterobacter spp. isolates, 31.36% were Enterobacter aerogenes (E. aerogenes), 20.34% Enterobacter agglomerans (E. agglomerans), 12.71% Enterobacter cloacae (E. cloacae), and 33.90% were other Enterobacter spp. All 118 (100%) Enterobacter isolates produced ESBLs. In the detection of ESBLs, CDT and PCR results were similar to each other and all 118 Enterobacter spp. were ESBLs producers (kappa = 1). Conclusions: According to the results, most of the Enterobacter spp. produced ESBLs and were Cefotaxime-M (CTX-M) enzyme carriers. Guidelines and appropriate use of antibiotics are necessary to avoid the production of ESBLs.