Library.

“The majority of Escherichia coli (E. coli) clinical isolates carry Extended-Spectrum Beta-Lactamase (ESBL) enzymes.”

Available global surveillance and meta-analytic data show fewer than half of all clinical E. coli isolates produce ESBL enzymes. Rates can exceed 50 % in certain hospitals or high-burden regions, but large multicountry datasets from WHO, ECDC, CDC, and a 78-study meta-analysis place the overall prevalence around 42 % or markedly lower in Europe and North America. Therefore, claiming most clinical E. coli isolates carry ESBL enzymes is not supported.

“In Indian ICU settings, Escherichia coli is the predominant ESBL-producing organism among gram-negative bacterial pathogens.”

Available ICU-focused evidence from India does not support E. coli as the leading ESBL-producing gram-negative organism. The most recent, large ICU datasets cited show Klebsiella pneumoniae is more common than E. coli in ICUs, and multiple bloodstream/hospital studies report Klebsiella as the top ESBL producer. Studies favoring E. coli mainly measure ESBL rates within E. coli or come from non-ICU settings, which cannot establish ICU-wide predominance.