Screening for Extended-spectrum β-lactamases, AmpC and Carbapenemases Producing Bacteria among Adult and Pediatric Intensive Care Unit Patients in Two University Hospitals in Egypt

Background: Emerging β-lactam resistant gram-negative bacteria (BLR-GNB) is a problem worldwide, particularly in the Intensive Care Units (ICUs). Objective: The aim of the present work was to evaluate the rate of carriage and the acquisition rate of BLR-GNB at one adult and one pediatric ICU in Alexandria University Hospitals, Egypt. Methodology: One hundred adult and 50 pediatric intensive care unit patients were included in the study. Rectal and nasal swabs were inoculated onto chromID ESBL (BioMerieux). The rate of carriage and the acquisition rate of BLR-GNB were calculated in both ICUs. All identified GNB were tested for ESBL, AmpC-β lactamase and carbapenemase production using combined disc, AmpC disc, and modified Hodge test (MHT) respectively. Results: Eighty eight percent of adult and 74% of pediatric patients were BLR-GNB carriers. The acquisition rate of BLR-GNB in adult & pediatric ICUs 48 hrs after admission was 42.9% and 35% respectively. Out of the 150-screened patients, 280 BLR-GNB isolates were identified where E. coli was the most commonly isolated (45%) followed by K. pneumoniae (35%). Conclusions: The high rate of BLR-GNB carriage calls for routine surveillance, which will be helpful for monitoring the spread of drug resistance in ICU settings.