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Background: Members of the family Enterobacteriaceae commonly express plasmid-encoded βlactamases (e.g., TEM-1, TEM-2, and SHV-1) which confer resistance to extended spectrum BetaLactam penicillins and cephalosporins. Aim: The present study was designed to estimate the prevalence of TEM, SHV, and CTX-M ESBL genes among common isolated Enterobacteriaceae and Pseudomonas. Methods: A nine months cross sectional study was carried out on 285 isolated pathogens from the main three major of Yemen governorates. Bacterial growth was identified according to standard methods. Entire CTX-M, SHV and TEM genes type were identified using PCR. Antimicrobial agent susceptibility was assessed according to the Kirby–Bauer method. Results: A total 134 of blaTEM, blaSHV and blaCTX-M genes were identified among 97 phenotyping ESBL producing pathogens as a single gene or accompany with others ESBL type genes. The prevalence of CTX-M was found higher among ESBL isolates (73/97, 75.3%), followed by TEM (49/97, 50.5%) and SHV (15/97, 15.5%). Frequency (%) of Escherichia coli harbouring CTX-M, TEM and SHV genes was found to be 86.0%, 44.2% and 4.7%, respectively. Similarly, the rate of Klebsiella pneumoniae carrying such genes was 66.7% (CTX-M), 56.9% (TEM) and 25.5% (SHV). Accordingly, CTX-M harboring isolates exhibited high resistance to Cefotaxime (84.9%) than Ceftazidime (58.9%). Similar result was also obtained among TEM and SHV-harboring isolates. On the other hand, the difference in the resistance of SHV as compared to TEM and CTX-M ESBL genes for Ceftazidime and Cefepeme was found to be statistically significant (OR = 3.9; P < 0. 018, OR = 4.4; P < 0. 046, respectively). Less resistance (53.4%) and decreased risk (OR=0.7) among CTX-Mproducers for Amoxiclave were reported. The rate of resistance was significantly increased among SHV producers (86.7%, OR = 6.5, P < 0.009) compared to others ESBL genes. Conclusion: This research is the first study to report the prevalence of TEM, SHV and CTX-M ESBL type genes in Yemen. The resistant of ESBL genes harboring isolates varies according to isolated strains and accompanies with others genes. [ABSTRACT FROM AUTHOR]

Background: To the best of our knowledge, in Yemen, size of endemic and epidemic extended spectrum beta-lactamase (ESBL) producing pathogens and its antibiotic resistance is unknown. Aim: This study was aimed to investigate the prevalence rate and antibiotic resistance of ESBL in Yemen. Methods: A nine months cross sectional study was carried out on 285 isolated pathogens from the three major governorates of the country (Sana’a, Aden and Taiz). Bacterial growth was identified according to standard methods. Antimicrobial agent susceptibility was assessed according to the Kirby–Bauer method. Results: The overall prevalence rate of ESBL producer was found to be 35.4% in Yemen. Klebsiella pneumoniae was the most common organisms producing ESBL. High prevalence rate of ESBLproducers was significantly reported in ICU (60.0%, OR= 3.0, P < 0.003). A higher rate of ESBLproducing isolates was found in Sana'a (65/148, 43.9%, OR=2.2, P < 0.002). K. pneumoniae was the main causative agents (40/65, 61.5%), which was significantly higher in Sana'a (OR= 3.7, P < 0.001) compared to Aden (17/69, 24.6%) and Taiz (19/68, 27.9%). Escherichia coli was the predominant ESBL-producer in Aden (12/35, 34.3%) and Taiz (12/33, 36.4%) governorates. Antibiotic resistance was significantly associated with ESBL producing isolates in all the governorates (OR = 4.0, P <0.001). In this study, the result of comparisons between antibiotic resistance of ESBL and non-ESBL producing isolates revealed that all ESBL isolates were significantly resistant to all tested antibiotics except Impenem. Conclusion: K. pneumoniae was the most commonly isolated ESBL producer and antibiotic resistance. Inpatients in general and intensive care units in particular are the epicenter of ESBL producing pathogens. Findings of this study can conclude that ESBL producing isolates are responsible for growing the resistance against new generations of beta lactam antibiotics as well as acquired co-resistance to other classes of antibiotics. [ABSTRACT FROM AUTHOR]