ESBL-PRODUCING ENTEROBACTERIACEAE IN ICU PATIENTS: PREVALENCE AND AMR PATTERNS IN PAKISTAN

Abstract

Background: Extended-Spectrum Beta-Lactamase (ESBL)-producing Enterobacteriaceae are an escalating threat to global healthcare, particularly in Intensive Care Units (ICUs), due to their capacity for multidrug resistance and nosocomial spread. Objective: To determine the prevalence and antimicrobial resistance profile of ESBL-producing Enterobacteriaceae among ICU patients in a tertiary care hospital. Methods: 100 clinical samples from ICU patients were processed using standard bacteriological methods. ESBL production was confirmed by phenotypic techniques including Combined Disk Test (CDT), Double Disk Synergy Test (DDST), and Three-Dimensional Test (TDT). Antimicrobial susceptibility was determined by the Kirby–Bauer method per CLSI 2024 guidelines. Results: Of 100 samples, 58 isolates belonged to Enterobacteriaceae, among which 42 (72.4%) were ESBL producers. E. coli (52.3%) and Klebsiella spp. (38%) were predominant. Resistance was highest to β-lactams and third-generation cephalosporins, while carbapenems remained effective. Conclusion: The high prevalence of ESBL-producing Enterobacteriaceae in ICU settings highlights an urgent need for robust antibiotic stewardship and infection control policies