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ESBL Klebsiella

ESBL-producing Enterobacterales in Healthcare Settings. Enterobacterales are a large order of different types of bacteria (germs) that commonly cause infections both in healthcare settings and in communities. Examples of germs in the Enterobacterales order include Escherichia coli ( E. coli) and Klebsiella pneumoniae Introduction. Klebsiella pneumoniae has been frequently found to produce extended-spectrum β-lactamases (ESBLs). 1 Infections caused by ESBL-producing pathogens are problematic because when co-resistance to other antimicrobial class is present, limited antibiotic options are available. Currently, imipenem or meropenem is regarded as the drug of choice for infections caused by ESBL-producing. Abstract. CTX-M extended-spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae isolates are infrequently reported in the United States. In this study, we analyzed nonduplicate ESBL-producing K. pneumoniae and Escherichia coli clinical isolates collected during 2005-2012 at a tertiary care medical center in suburban New York City, USA, for the presence of bla CTX-M, bla SHV, bla TEM. Medications. Possible medications used to treat ESBL infection include: carbapenems, which are useful against infections caused by E. coli or Klebsiella pneumoniae bacteria; fosfomycin, which is.

EPIDEMIOLOGY OF ESBL E. COLI AND K. PNEUMONIAE UROPATHOGENS. The first transferrable β-lactamase was named TEM, after the name of a patient in Greece in the early 1960s with an E. coli-positive blood culture. 4 The first ESBL enzyme of sulphydryl variable type was identified in a Klebsiella strain isolated in Germany in 1983. 6 Until 2000, ESBL-producing Enterobacteriaceae caused mainly. Niinpä kolibakteeri (E. coli), jolla on ESBL-ominaisuus, voi siirtää plasmidinsa ja antibiootteja hajottavan ominaisuutensa Klebsiella-bakteeriin. Kun bakteerit, joille on tällä tavalla syntynyt ESBL-ominaisuus, joutuvat alttiiksi antibiooteille, ne säilyvät hengissä paremmin kuin lääkkeille herkät edeltäjänsä

ESBL-ominaisuus tekee bakteerin vastustuskykyiseksi tavallisesti hoidossa käytetyille antibiooteille. Näitä bakteereja kutsutaan ESBL-bakteereiksi, sillä ne tuottavat antibiootteja pilkkovia entsyymejä (extended spectrum beta-lactamases, ESBL). Bakteerit, joilla voi olla ESBL-ominaisuus, ovat esimerkiksi Escherischia coli ja Klebsiella. Enterobacteriaceae strains producing ESBL was done by the difusimetric Kirby-Bauer method and VITEK 2 COMPACT system. The highest percentage of the ESBL strains was registered in Escherichia coli (46.2%), followed by Klebsiella sp. (23.2%) and Enterobacter sp. (20.3%). With lower frequencies have been isolated ESBL strains o Flera olika tarmbakterier kan bilda dessa enzym, de vanligaste är Escherischia coli (E. coli) och Klebsiella pneumoniae. ESBL-bildande bakterier påträffas både inom vården och i samhället och både hos sjuka och friska individer. Det är vanligt att vara frisk bärare av ESBL i tarmen, så kallat asymtomatiskt bärarskap ESBL - Klebsiella pneumoniae ESBL-kantaja ESBL-altistunut Muu riski (osastohoitoon tulevilla) Määritelmä - riskitiedoissa on merkintä ESBL- K.pneumoniae-kantajuudesta 12 kk sisällä - näytteestä löytyy ESBL- K.pneumoniae - riskitiedoissa on merkintä ESBL- K.pneumoniae-altistuksesta - epidemiaepäilyissä/ epidemiatilanteiss

ESBL-producing Enterobacterales HAI CD

  1. BACKGROUND Despite a reported worldwide increase, the incidence of extended-spectrum β-lactamase (ESBL) Escherichia coli and Klebsiella infections in the United States is unknown. Understanding the incidence and trends of ESBL infections will aid in directing research and prevention efforts. OBJECTI
  2. What illnesses do ESBL producing bacteria cause? The most common bacteria that produce these enzymes are E. coli and Klebsiella which are bacteria that can live in your bowel without you being unwell or showing any signs or symptoms of infection (this is referred to as colonisation)
  3. Abstract. The prevalence of extended-spectrum β-lactamase (ESBL) production by Klebsiella pneumonia approaches 50% in some countries, with particularly high rates in eastern Europe and Latin America. No randomized trials have ever been performed on treatment of bacteremia due to ESBL-producing organisms; existing data comes only from retrospective, single-institution studies
  4. 1 Definition. Extended-Spectrum-Betalaktamasen, kurz ESBL, sind bakterielle Enzyme (Betalaktamasen), die ein erweitertes Spektrum Betalaktam-haltiger Antibiotika spalten können.. 2 Genetik. Die ESBL entstehen entweder durch eine Punktmutation einer gewöhnlichen Betalaktamase oder sie stammen ursprünglich von harmlosen Umweltkeimen.Die ESBL-codierenden Gene können über Resistenzplasmide.
  5. Management of ESBL gram negative bacteremia- the Merino Study Charles Krasner, M. D. ( Staph, Strep)- cell wall on the outside Gram negatives ( E.coli, Klebsiella, pseudomonas )- cell wall sandwiched inside 2 membranes . The β lactam antibiotics-all have a β lactam ring that allows it to bind to and inactivate the enzymes (referred to as.

Klebsiella can cause severe infections in your lungs, bladder, brain, liver, eyes, blood, and wounds. Your symptoms depend on the type of infection. The infection spreads through person-to-person. rezerwuarem wieloopornych szczepów E. colii Klebsiella. Podawanie doustne antybiotyków takich jak kotrimoksazol i fluorochinolony sprzyja kolonizacji rezydentów ośrodków opieki długoterminowej tym samym typem szczepu. Rozprzestrzenienie się bakterii wytwarzających ESBL w tym przypadku jest związane z trudnościami w zastosowani General Information. Klebsiella [kleb−see−ell−uh] is a type of Gram-negative bacteria that can cause different types of healthcare-associated infections, including pneumonia, bloodstream infections, wound or surgical site infections, and meningitis. Increasingly, Klebsiella bacteria have developed antimicrobial resistance, most recently to the class of antibiotics known as carbapenems Introduction: Frequent use of different antibiotics to treat urinary tract infections (UTIs) exerts a variety of selective pressure on pathogens which ultimately lead to the antimicrobial resistance. Extended Spectrum βeta-Lactamase (ESBL) producing Enterobacteriacae causing UTIs, which are usually multidrug resistant organisms, pose a great therapeutic treatment challenge Sedan mars 2012 är Enterobacteriaceae (E. coli, klebsiella m fl) med ESBL CARBA, anmälnings- och smittspårningspliktiga enligt smittskyddslagen för behandlande läkare. För övriga fall av ESBL-bärande bakterier gäller fortsatt enbart laboratorieanmälan

Clinical implications of extended spectrum beta-lactamase (ESBL) producing Klebsiella species and Escherichia coli on cefepime effectiveness. J Infect 2005; 51:211. Seo YB, Lee J, Kim YK, et al. Randomized controlled trial of piperacillin-tazobactam, cefepime and ertapenem for the treatment of urinary tract infection caused by extended-spectrum. ESBL. 72 73. Introduction . 74. Klebsiella pneumoniae. is an important human pathogen . 1. and acknowledged as a key host for the 75. spread of antimicrobial resistance (AMR) 2, 3. The global spread of multidrug resistance (MDR) 4. K. 76 . pneumoniae

Laboratory detection of ESBL

ESBL-producerende bakterier er resistente over for en stor gruppe af almindeligt anvendte antibiotika, der rækker fra bredspektrede penicillinpræparater til mere specialiserede antibiotika som cephalosporiner. Dette gør det vanskeligere at behandle og forebygge infektioner. Resistensforekomst af ESBL-typen regnes ifølge WHO som en af de største trusler mod verdenssundheden ESBL ble på 1980- og 1990-tallet hovedsakelig funnet hos ulike Klebsiella-arter hos sykehuspasienter i intensivavdelinger, men de siste årene er de også funnet i økende grad også hos E. coli-bakterier og andre enterobakterier. Det er foreløpig særlig gramnegative tarmbakterier som kan produsere ESBL This study aimed to assess the prevalence of ESBL producing E. coli and Klebsiella spp. at a tertiary hospital in Nepal. Methods A total of 2209 non-repetitive mid-stream urine (MSU) samples were. What is extended spectrum beta-lactamase? Some germs, such as Escherichia coli (E. coli) and Klebsiella, produce an enzyme called extended spectrum beta-lactamase (ESBL). This enzyme makes the germ harder to treat with antibiotics. ESBL can cause a variety of illnesses, including: Urinary tract infections (UTIs) Pneumonia; Blood infections.

de ESBL em 2005, aumentando de forma muito considerável até atingir os 226 isolamentos em 2012. De igual forma, em relação às Klebsiella pneumoniae produtoras de ESBL, constata-se o iso-lamento de 33 em 2005 e 167 em 2012. Estes resultados ilustram a real e preocupante dimensão da incidência nacional deste tipo de bactérias Escherichia coli and Klebsiella pneumoniae are two common ESBL-producing Enterobacteriaceae found worldwide, 4 and cause various infections, such as urinary tract infections (UTIs), intra-abdominal infections, and bacteremia in both nosocomial and community settings.3, 5, 6 Yu et al summarized the published data about the epidemiology of ESBL.

pattern of extended-spectrum beta-lactamase producing Klebsiella spp. isolated from cases of neonatal septicaemia. Indian J Med Res. 2007;125(1):89-94. 14. Dalela G. Prevalence of extended spectrum beta-lactamase (ESBL) producers among gram-negative bacilli from various clinical isolates in a tertiary care hospital at Jhalawar, Rajasthan, India CTX-M type ESBLs are the most prevalent ESBL types worldwide and are commonly associated with ST131 E. coli. Carbapenemases: Klebsiella pneumoniae carbapenemase, KPC (Ambler Class A): confers broad resistance and is associated with mortality rate >50%. Many isolates in US are sequence type, ST258 Of the 100 clinical isolates of Klebsiella pneumoniae, 39 were screened according to CLSI guidelines and selected for conformational tests of ESBL.The two techniques were used in the present study to confirm ESBL-producing Klebsiella pneumoniae, namely, DDST and PCDDT and confirmed 28% hospital and 6% community isolates were the ESBL producers. The results (Table 2) showing that of the 17. Klebsiella pneumoniae and Klebsiella oxytoca were identified by cultural and biochemical methods. Antibiotic sensitivity test was per-formed by modified Kirby-Bauer disc diffusion technique. ESBL production in Klebsiella spp. was confirmed by double disc synergy test. Results and Conclusion: Out of 500 clinical isolates, 120 were foun In general, ESBL infections have increased from 1997 to 2011, with a slightly higher incidence rate for ESBL-Klebsiella infections compared with ESBL-E. coli infections. Other studies not included in this systematic literature review also reported increased ESBL infections when examining the proportion E. coli and Klebsiella tha

Treatment of ESBL-producing Klebsiella pneumoniae

Rupp ME, Fey PD. Extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae. Drugs. 2003;63(4):353-65. Paterson DL, Ko W-C, Von Gottberg A, Mohapatra S, Casellas JM, Goossens H, et al. Antibiotic therapy for Klebsiella pneumoniae bacteremia: implications of production of extended-spectrum β-lactamases ESBL stands for extended-spectrum beta-lactamases and designates enzymes which alter a broad spectrum of beta-lactam antibiotics, thus making them ineffective. Klebsiella and Escherichia. We sequenced the available isolates to determine the phylogenetic relatedness of Klebsiella pneumoniae isolates on the basis of their genome sequences. Results The investigation comprises 37 cases and the 10 cases with ESBL (extended-spectrum beta-lactamase)-producing K. pneumoniae bloodstream infection Extended-spectrum beta-lactamase (ESBL) producing bacteria . What are ESBLs? Extended-spectrum beta-lactamases (ESBLs) are enzymes produced by some species of Enterobacteriaceae (also known as coliforms) such as . E. coli . and . Klebsiella. species that are part of the normal intestinal flora of humans and many animals Methods: A nonredundant collection of 757 strains of E. coli, Klebsiella pneumonia, Klebsiella oxytoca and Enterobacter cloacae resistant to third generation cephalosporins and ESBL positive by VITEK II analysis was analyzed by PCR for presence of beta-lactamase genes of the TEM, SHV, CTX-M and ampC families

CTX-M β-Lactamase-producing Klebsiella pneumoniae in

Klebsiella oxytoca is an opportunistic pathogen that causes primarily hospital-acquired infections, most often involving immunocompromised patients or those requiring intensive care. Reported outbreaks have most frequently involved environmental sources (1-4).K. oxytoca, like other Enterobacteriaceae, may acquire extended-spectrum β-lactamases (ESBL) and carbapenemases (1,5); outbreaks of. In this study, we investigated the molecular characteristics of extended-spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae isolates that were recovered from an outbreak in a Korean hospital. A new multilocus sequence typing (MLST) scheme for K. pneumoniae based on five housekeeping genes was developed and was evaluated for 43 ESBL-producing isolates from an outbreak as well as 38. The emergence of extended-spectrum-β-lactamases (ESBLs)-producing Klebsiella pneumoniae (ESBL-KP) represent a serious clinical concern in both healthcare and community settings 1,2,3.ESBL. Active surveillance of the Gram-negative pathogenic bacteria K. oxytoca and Klebsiella pneumoniae that produce ESBL and carbapenemases enzymes is an essential function of hospital laboratories. Further, K. oxytoca has shown reduced sensitivity to the widely used antiseptic, chlorhexidine. 13 This will undoubtedly increase the further burden of.

ESBL産生菌は、基質特異性拡張型βラクタマーゼ(Extended spectrum β-lactamases:ESBL)とよばれる酵素を産生する細菌の総称です。. 薬剤耐性菌の一種であり、大腸菌、肺炎桿菌、プロテウス・ミラビリス等の腸内細菌から多く検出されています。. 近年では日本で. ESBL producing E. coli and Klebsiella species cause severe infections in humans even in countries with advanced public health and health care facilities [5, 6]. And most of infections are associated with cross contamination in hospital and clinic settings Klebsiella spp. are associated with several nosocomial and opportunistic infections. Increasing antimicrobial resistance of Klebsiella species is aggravated by a number of intrinsic and extrinsic factors. The main aim of this study is to determine antimicrobial resistance due to production of β-lactamase enzymes, extended spectrum beta-lactamase (ESBL), metallo-beta-lactamase (MBL) and AmpC. ESBLs are resistant to most types of antibiotics (third generation). The majority of ESBL producing strains are either klebsiella pneumoniae (K. pneumoniae), klebsiella oxytoca (K. oxytoca) and Escherichia coli (E. coli). The ESBL producing strains of E. coli are different from the E. coli O157 that cause food poisoning infections

Průkaz beta-laktamáz širokého spektra (ESBL) a typu AmpC u

Objective Several studies reported that infection of extended-spectrum β lactamase (ESBL)-producing Escherichia coli (E. coli) or Klebsiella pneumoniae (K. pneumoniae) contributed to higher mortality rates but others found it was not associated with mortality. A prospective cohort study which involved 72 patients was conducted to assess the risk of mortality of bloodstream infection due to. Background/Purpose. For extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae infections, carbapenems are recommended as first line therapy, and clinical data on the therapeutic efficacy of fluoroquinolones (FQs) is limited. This study compares the efficacy of FQs and carbapenems for bloodstream infections caused by ESBL-producing Escherichia coli or Klebsiella pneumoniae Rod Klebsiella patří mezi opouzdřené gramnegativní nepohyblivé tyčky.Bakterie tohoto druhu jsou součástí mikrobiální flóry GIT a respiračního ústrojí, ve vnějším prostředí je nalézáme v půdě i ve vodě. Jedná se o podmíněně patogenní bakterie. Nejvýznamnějším druhem je Klebsiella pneumoniae, mezi další patří například Klebsiella oxytoca ESBL-producing Enterobacteriaceae started to appear in the 1980s, and have since emerged as some of the most significant hospital-acquired infections with Escherichia coli and Klebsiella sp. being the main actors but other Gram-negative species have also been observed ESBL? • Resistance that is produced through the actions of beta-lactamases. • Extended spectrum cephalosporins, such as the third generation cephalosporins, were originally thought to be resistant to hydrolysis by beta-lactamases! • Not so! - mid 1980's it became evident that a new type of beta-lactamase was being produced by Klebsiella.

ESBL: Transmission, Treatments, and Mor

Extended spectrum beta lactamase pneumoniae in Children: Epidemiology and Clinical Outcome. production & multidrug resistance in Klebsiella species isolated from Antimicrob. Agents Chemother. 46(5): 1481-1491. 553-6. Lee CH, Su LH (2006). Treatment of ESBL-producing Klebsiella Tokatlidou D, Tsivitanidou M (2008). Outbreak caused by a. Queenan AM, Foleno B, Gownley C, Wira E, Bush K. Effects of inoculum and b-lactamase activity in AmpC- and extended-spectrum b-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae clinical isolates tested by using NCCLS ESBL methodology

We report an outbreak of ESBL-producing Klebsiella pneumoniae (ESBL-K. pneumoniae) that occurred in a rehabilitation center in Rotterdam, Netherlands, in 2016. Our description focuses on (1) the microbiological analysis including source identification and (2) the outbreak measures taken in the context of the rehabilitation setting A recent study by McDanel and colleagues showed an increase in the incidence of ESBL-producing E coli and Klebsiella species from 1997 to 2011 in the U.S. In 2017, the incidence of ESBLs was about 16.64 infections per 10,000 discharges. 8 The prevalence of ESBLs has also been increasing throughout the rest of the world, especially in Asia. Klebsiella is a genus of Gram-negative, oxidase-negative, rod-shaped bacteria with a prominent polysaccharide-based capsule.. Klebsiella species are found everywhere in nature. This is thought to be due to distinct sublineages developing specific niche adaptations, with associated biochemical adaptations which make them better suited to a particular environment Extended Spectrum β-Lactamase (ESBL)-Producing Enterobacteriaceae Considerations for Diagnosis, Prevention and Drug Treatment Mark E. Rupp and Paul D. Fey Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska, US

1 Definition. Klebsiella pneumoniae ist ein humanpathogenes, gramnegatives Stäbchenbakterium der Gattung Klebsiella, das unter anderem Pneumonien auslösen kann.. 2 Eigenschaften und Morphologie. Klebsiella pneumoniae ist ein stabförmiges Bakterium, das keine Sporen ausbildet. Da es keine Geißeln besitzt ist es unbeweglich, Fimbrien hingegen sind vorhanden.. 46 ORIGINAL ARTICLE Karakterizacija ESBL-producirajućih sojeva bakterija Escherichia coli i Klebsiella pneumoniae izoliranih iz mokraće izvanbolničkih pacijenata zagrebačke regije Tatjana Marijan 1, Vanda Plečko2, Jasmina Vraneš, Ana Mlinarić Džepina1, Branka Bedenić2, Smilja Kalenić2 1Zavod za javno zdravstvo Dr. Andrija Štampar; 2Klinički bolnički centar Zagreb; Zagreb. I membri del genere Klebsiella sono batteri Gram negativi, patogeni opportunisti, implicati in una vasta gamma di malattie e praticamente ubiquitari in natura. Negli ultimi anni, le infezioni di cui sono responsabili hanno assunto una notevole importanza, in quanto sono spesso acquisite in ambienti sanitari. Le infezioni possono diffondersi rapidamente tra pazienti ospedalizzati per altre. Klebsiella pneumoniae is a Gram-negative, non-motile, encapsulated, lactose-fermenting, facultative anaerobic, rod-shaped bacterium.It appears as a mucoid lactose fermenter on MacConkey agar.. Although found in the normal flora of the mouth, skin, and intestines, it can cause destructive changes to human and animal lungs if aspirated, specifically to the alveoli resulting in bloody, brownish.

Treatment of Urinary Tract Infections Caused by ESBL

The definition of hypervirulent Klebsiella pneumoniae (hvKp), traditionally regarded as hypermucoviscosity, is controversial. However, data based on both phenotype (hypermucoviscous) and genetic (aerobactin) criteria are limited. A retrospective study was conducted in 175 geriatric patients between January 2008 and January 2014. The clinical and molecular data, including antimicrobial. A 14% global prevalence of Extended-Spectrum Beta-lactamase (ESBL) carriage was recently reported, but large intra-and interregional variations were observed. We investigated the faecal carriage rates of ESBL-, AmpC-producing and ciprofloxacin non-susceptible Escherichia coli and Klebsiella spp. in healthy Norwegians Klebsiella pneumoniae: Growing worldwide resistance to a broad array of antibiotics. Therapy should be guided by susceptibility testing. Extended spectrum beta-lactamase and carbapenemase production is a growing problem. Susceptible strains: Ceftriaxone 1-2 grams IV q24h (range: 1-2 grams q12-24h

ESBL- ja CPE-bakteerit - Terveyskirjast

Video: ESBL - Infektiotaudit ja rokotukset - TH

ESBL (Extended Spectrum Beta-Lactamase) - Vårdhandboke

Även multiresistenta, ESBL-producerande stammar av E. coli är oftast känsliga för nitrofurantoin (andelen resistenta stammar < 5 %). Nitrofurantoin ger höga urinkoncentrationer men inga terapeutiska vävnadskoncentrationer. Det är ett förstahandsval vid empirisk behandling av akut cystit men ska inte användas för behandling av febril UVI The aim of this work was to investigate the epidemiological and genetic characteristics of ESBL-producing Klebsiella pneumoniae (ESBL-Kp) causing community-onset infections. K. pneumoniae isolates were collected from 31 Chinese secondary hospitals between August 2010 and 2011. Genes encoding ESBL and AmpC beta-lactamases were detected by PCR

Incidence of Extended-Spectrum β-Lactamase (ESBL

Extended spectrum β-lactamase (ESBL)-producing organisms pose unique challenges to clinical microbiologists, clinicians, infection control professionals and antibacterial-discovery scientists. ESBLs are enzymes capable of hydrolysing penicillins, broad-spectrum cephalosporins and monobactams, and are generally derived from TEM and SHV-type enzymes. ESBLs are often located on plasmids that are. Treatment of Klebsiella pneumonia has discrepant results. For patients with severe infections, a clinically prudent approach is the use of an initial short course (48-72 h) of combination therapy with an aminoglycoside, followed by a switch to an extended-spectrum cephalosporin when susceptibility is confirmed

What is ESBL? - Patient Information and Leaflets SAS

The ESBL were phenotypically detected in 87/91 (95.60%) E. coli and 62/64 (96.88%) Klebsiella spp. strains. Distribution of qnr genes. Electrophoresis analysis revealed 107 strains (61 E. coli and 46 Klebsiella spp.) harboring at least one qnr gene: 74 (47.74%) qnrB (41 E. coli and 33 Klebsiella spp.), 73 (47.10%) qnrS (48 E. coli and 25 Klebsiella spp.) and 4 (2.58%) qnrA (Klebsiella spp. only) ESBL-negative and Klebsiella pneumoniae 700603 was used as an ESBL-positive reference strain.(19) RESULT During the 4-month period, a total of 2202 urine samples were processed for culture and sensitivity testing. Of the total urine samples studied, 92 (4.1%) showed mixed bacterial growth may be due to improper specimen collection or delay. ESBL means Extended Spectrum Beta-Lactamase producing organism. ESBL enzymes are normally produced by micro-organisms in the bowel, such as E. coli and Klebsiella. The enzymes break down antibiotics (making them ineffective), and subsequently infections become more difficult to treat Detailed reports regarding the distribution and activity of extended-spectrum beta-lactamase (ESBL)-producing Klebsiella pneumoniae isolates are currently not widely available in the Malaysian setting. This study was conducted to determine the ESBL genes distribution rate, phenotypic detection, and antimicrobial susceptibility patterns among beta-lactam resistant Klebsiella pneumoniae isolated.

Antibiotic Therapy for Klebsiella pneumoniae Bacteremia

Extended-Spectrum-Betalaktamase - DocCheck Flexiko

Klebsiella pneumoniae – scheda batteriologica edPathology Outlines - Klebsiella oxytocaPPT - Carbapenem Resistance in Enterobacteriaceae

Rapid detection and reporting of third generation cephalosporine resistance (3GC-R) and of extended spectrum betalactamases in Enterobacteriaceae (ESBL-E) is a diagnostic and therapeutic priority to avoid inefficacy of the initial antibiotic regimen. In this study we evaluated a commercially available chromogenic screen for 3GC-R as a predictive and/or confirmatory test for ESBL and AmpC. Answer . The increase in ESBL-producing E coli (ESBL-EC) among community-onset urinary tract infections (UTI) is an important public health concern as these organisms are resistant to multiple antimicrobial agents. 1-3 ESBL enzymes are able to hydrolyze most of the beta-lactam antibiotics, including third-generation cephalosporins. 1 In addition, ESBL-EC can also have co-resistance to SMX/TMP. K. oxytoca specific beta lactamase, bla OXY ( J Antimicrob Chemother 2015;70:3230 ) Klebsiella spp. are ESKAPE pathogens ( Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter) which often are multidrug resistant ( Clin Infect Dis 2009;48:1 In this study, we retrospectively characterized 19-ESBL-positive E. coli, and 42-ESBL-positive K. pneumoniae isolates obtained from an outbreak of infection at a neonatal intensive care unit (NICU) in the Ha'il region of Saudi Arabia ESBL's worden voornamelijk aangetroffen in enterobacteriaceae, een groep van (Gram-negatieve) bacteriën die behoren tot de normale darmflora van mens en dier en waarvan de AR attack rate en Klebsiella spp species. de meest voorkomende zijn. Enterobacteriaceae zijn de meest voorkomende verwekkers van urineweginfecties en zijn verantwoordelijk.