In vitro activity of 13 antibiotics against CTX-M ESBL-positive and negative clinically significant Escherichia coli isolates from 8major hospitals in Kuwait

Abstract number: P663

Al Hashem G., Al Sweih N.A., Jamal W., Rotimi V.O.

Objective: The objective was to evaluate the antibiotic susceptibility of Escherichia coli, an important community and hospital pathogen, isolated from 8 Kuwait hospitals.

Methods: A total of 846 consecutive clinically significant strains of E. coli were studied during a one-year period. In vitro activity of 13 antibiotics against the isolates was determined by Etest. ESBL-production was assessed by ESBL-Etest method and confirmed by PCR technique. PCR amplicons positive for blaCTX-M were sequenced.

Results: About 69% of the E. coli isolates were highly non-susceptible to ampicillin with MIC90 of 256 mg/ml. Resistance to the 3rd generation cephalosporins ranged from 7.5% in Maternity hospital (MH) to 29% in Ibn Sina hospital (ISH); ciprofloxacin resistance rates ranged from 14% and 40%, respectively. Carbapenems and amikacin demonstrated excellent activities. Prevalence of ESBL-producing E. coli varied from hospital to hospital, with highest rate (32%) from ISH and lowest (4%) from Mubarak hospital and MH. MIC90 of cefotaxime, ceftazidime, cefepime and ciprofloxacin were >256, 64, >256 and >32 mg/ml, respectively for CTX-M-positive isolates versus 0.5, 1, 025 and 0.125 mg/ml for CTX-M-negative strains. Frequencies of CTX-M-positive isolates in cefotaxime MIC range of 1–2, 3–8, 9–16 and >16 mg/ml were 0, 4, 15 and 81%, respectively.

Conclusion: The prevalence of E. coli resistant to the 3rd generation cephalosporins and ciprofloxacin is at an unacceptable level. This is compounded by a high incidence of CTX-M ESBL-producing strains in almost all hospitals in Kuwait.

Session Details

Date: 16/05/2009
Time: 00:00-00:00
Session name: 19th European Congress of Clinical Microbiology and Infectious Diseases
Location: Helsinki, Finland, 16 - 19 May 2009
Presentation type:
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