Occurrence of extended-spectrum b-lactamase producers among enterobacteriaceae in a paediatric tertiary care facility in Kabul.

The aim of this study was to determine the occurrence of extended spectrum beta-lactamase (ESBL)-producing species of Enterobacteriaceae to control their spread, from March 2008 to June 2012. A total of 411 ESBL-producing isolates were reported belonging to the family Enterobacteriaceae. There were 235 (57.18%) hospital-acquired infections (HAIs) and 176 (42.82%) community-acquired infections (CAIs). Out of total isolates, majority were E. coli (n=165, 40.15%), followed by 38.93% Klebsiella spp. (n=161), 9.97% Enterobacter spp. (n=41) and 6.33% Serratia spp. (n=26). Amongst HAIs, most frequent i.e., 111/235 (47.23%) were Klebsiella spp, whereas, amongst CAIs, majority i.e., 96/176 (54.55%) were E. coli. The frequency of ESBL-producing isolates from different sites was blood (37.71%), urine (29.93%), respiratory tract (18.49%) and other sites including pus/pus swabs, CSF/body fluids and secretions (13.87%) respectively. Majority of blood stream infections were caused by ESBL-producing Klebsiella species which accounted for 55.48% of all cases who had septicaemia, whereas E. coli was responsible for causing majority of urinary tract infections (UTIs) and accounted for 78% of all UTIs cases. Intensive Care Unit (ICU) was the place where majority of infections (55%) were observed, followed by 29% in the Medical Unit and 16% in the Surgical Unit.