Extended-spectrum beta-lactamase(ESBL) in Omani Children Study ofprevalence, risk factors andclinical outcomes at Sultan Qaboos University Hospital, Sultanate of Oman

Antimicrobial resist ance is a growing pro blem worldwide, which imposes difficu lties in the selection of appropriate em pirical anti microbial th erapy. This study evaluated extended-s pectrum beta- Iactamase (ESBL) isolates in 2005 in The Department of Child Healt h at Sultan Qaboos Univers ity Hos pita l (SQUH), Oman. Meth ods: Dur ing the 12 month period from January 2005 to December 2005, ESBL isolates from paediatri cs inpat ients were identified and analysed . Risk factors for the patie nts who grew ESBLs were analysed . Results: 13.3% of E. coli and 16.6% of Klebsiella pneumoniae isola ted were ESI3L producers. Most of the ESBLs were from ur ine (4 6 .2%) and bloo d (4 2.6%). The main risk factors for ESBL in these ch ildren were previous exposur e to antimicrobials (100%), prolonged hospital stay, severe illness (92.3%) and female gende r (84.6%). Sensitivity of 100% was observed to carbape nems whereas 9 2% of the isolates were susceptible to arnikacin. The oxirnino-cephalosporins were 100% resis tant. Klebsiella pne umoniae were 100% resistan t to pipe rac illin- tazobactam and nitrofurantoin . E. coli was 100% resist ant to tr imet hoprim -sulfarnethoxazole and ciprofl oxacin . No resistance was recorded for the following combinations: ami kacin plus piperacillin-t azob actarn, am ikacin plus nit ro fur antoin and gen tamici n plus nitro fu ran toin. Conclusion: ESBL-produc ing orga nisms are becomi ng a major pro blem in Oma ni childr en . Expos ure to anti microbials and lon g admissions are modifiable risk facto rs that should be tar geted for better contr ol. Carbapenems are the most sensitive and reliable treatment op tion s fo r infec tions caused by ESBLs. Amikacin plus pip erac illin- tazo bactam or nitrofurantoin are good altern atives.