A high prevalence of multi-drug resistant Gram-negative bacilli in a Nepali tertiary care hospital and associated widespread distribution of Extended-Spectrum Beta-Lactamase (ESBL) and carbapenemase-encoding genes

Table 4 Association between ESBL positivity, MDR or non-susceptibility to cephalosporins and presence of resistance genes

Genes	ESBL	non-ESBL	OR (95% CI)^c	p-value^d
bla_OXA^a
OXA-neg	406	458
OXA-pos	674	604	1.3 (1.1–1.5)	0.009
bla_CTXM^b
CTXM-neg	112	660
CTXM-pos	968	401	14.2 (11.2–18.1)	< 0.001
bla_TEM
TEM-neg	262	517
TEM-pos	818	545	3.0 (2.5–3.6)	< 0.001

Genes	MDR	non-MDR	OR (95% CI)^c	p-value^d
bla_OXA^a
OXA-neg	751	113
OXA-pos	1198	80	2.3( 1.7–3.1)	< 0.001
bla_CTXM^b
CTXM-neg	629	143
CTXM-pos	1319	50	6.0 ( 4.2–8.6)	< 0.001
bla_TEM
TEM-neg	680	99
TEM-pos	1269	94	2.0 ( 1.4–2.7)	< 0.001

Genes	Cephal. ¾ non-susceptible	Cephal. ¾ susceptible	OR (95% CI)^c	p-value^d
bla_OXA^a
OXA-neg	825	35
OXA-pos	1244	26	2.0 ( 1.2–3.5)	0.008
bla_CTXM^b
CTXM-neg	710	54
CTXM-pos	1358	7	14.7 ( 6.6–38.6)	< 0.001
bla_TEM
TEM-neg	746	27
TEM-pos	1323	34	1.4 (0.8–2.4)	0.22

Cephal. 3/4, 3rd or 4th generation cephalosporin
^aAn isolate was classified as bla_OXA positive if bla_{OXA1_4_30}, bla_OXA, bla_OXA-23, bla_OXA-24, bla_OXA-48, bla_OXA-51 or bla_OXA-58 was detected
^bAn isolate was classified as bla_CTXM positive if bla_CTXM-1, bla_CTXM-2, bla_CTXM-8, bla_CTXM-9 or bla_CTXM-25 was detected
^cOdds ratio (OR and 95% CI) of bacterial isolate to be ESBL positive, multi-drug resistant or resistant to 3rd or 4th generation cephalosporin in the presence of a respective gene (gene family)
^dp-value from Fisher’s exact test

ISSN: 1476-0711