Incidence of Beta-Lactamase Production among Out Patient Clinical Isolates in Middle Eastern Countries and Their Antibiotic Susceptibilities

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Abstract
In a multicenter survey in seven Middle Eastern countries, 1,827 clinical isolates from patients with community-acquired infections (outpatients) were examined for both production of β-lactamase and their susceptibility to commonly prescribed antibiotics. Of these isolates, 63% were gram-negative and 37% were gram-positive organisms, β-lactamase was produced by 65% of all isolates, representing 61 and 75% of gram-negative and gram-positive organisms, respectively. Using standardized disk susceptibility testing, high rates of resistance were observed among gram-negative and gram-positive organisms, respectively, for penicillin (86 and 75%), ampicillin (67 and 66%) and amoxicillin (58 and 52%). Resistence to tetracycline and co-trimoxazole were also seen, but to a lesser degree. Susceptibility of these organisms towards the cephalosporins cephradine, cephalexin and cefadroxil ranged from 30 to 70%, which appears to correlate fairly closely with the prevalence of β-lactamase production. Cefuroxime inhibited about 94 and 79% of gram-positive and gram-negative organisms, respectively, regardless of the production of β-lactamase. These data are valuable since antibiotic therapy is usually instituted on a best-guess principle against the most likely potential pathogens.

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