Epidemiology of Extended-Spectrum Beta-Lactamases (ESBLs)-Producing Bacteria in Different Regions in Saudi Arabia: A Systematic Review

Recently, a number of Saudi studies have indicated the emergence of a new genetic mutation in gram-negative bacteria (GNB) strains, particularly in extended spectrum beta-lactamase (ESBL) producing isolates, which accounts for about 8% to 38% of the total GNBs detected at Saudi hospitals. ESBLs are enzymes identified in GNB and have ability to resist beta lactam antimicrobial agents by breaking down the lactam ring. To ensure the objectiveness of this study, this paper presents most of the published studies on ESBL infection in Saudi Arabia (available online). ESBL-producing bacteria were detected using disk diffusion methods, dilution methods, double-disc synergy test, E-test strip and molecular detection methods. Risk factors contributing to the spread of ESBL infection include renal disease, diabetes, age, gender, hospital admission and previous exposure to antibiotics. CTX-M, TEM and SHV genotypes are the most common in the studies that have been performed in Saudi hospitals. Imipenem, meropenem, tigecycline and nitrofurantoin are still the best options to treat the ESBL infection. Appropriate infection control policies should be applied to reduce the risk factors of such infections.