Prevalence of Extended-Spectrum β-Lactamase-producing Enterobacterales and Distribution of bla<inf>ESBL</inf> Genes from Patients who Underwent Abdominal Surgery

Abstract

The proliferation of extended-spectrum β-lactamase-producing Enterobacterales (ESBL-PE) is a serious global health problem. Screening for ESBL-PE from rectal swabs of patients who underwent abdominal surgery and determination of blaESBL genes were performed. E. coli producing the extended-spectrum β-lactamase enzyme (ESBL) (77.41%) and ESBL-producing K. pneumoniae (12.9%) were found in 31 out of 104 patients. The most prevalent blaESBL in both E. coli and K. pneumoniae were blaTEM and blaOXA-2, whereas blaSHV was most prevalent only among K. pneumoniae. In contrast, blaCTX-M and blaOXA-10 were the least detected in E. coli and K. pneumoniae. The fecal ESBL producers isolated from swabs taken prior to and after abdominal surgery illustrated persistence of colonization in patients’ guts. Multiple-drug resistant bacterial infections found among ESBL carriages appeared to be associated with prolonged hospitalization and underlying complex diseases. It is essential that healthcare professionals are cognizant of the importance of monitoring for the presence of these ESBL producers, and reducing both intra-abdominal surgery site infections and the spread of resistance genes in prolonged fecal ESBL carriages in high-risk patients.