Antimicrobial susceptibility tests were performed on Mueller–Hinton agar (Himedia, India) using commercial antimicrobial discs (BD BBL, USA), based on standard disk diffusion method and according to the guidelines of the clinical and laboratory standards institute (CLSI) [15]. The antibiotic discs were ampicillin (10 μg), amikacin (30 μg), ceftazidime (30 μg), cefotaxime (30 μg), ciprofloxacin (5 μg), ertapenem (10 μg), imipenem (10 μg), levofloxacin (5 μg), piperacillin–tazobactam (100 μg + 10 μg), tetracycline (30 μg) and trimethoprim–sulfamethoxazole (1.25 μg + 23.75 μg). Multidrug resistance was defined by discerning non-susceptibility to at least 1 antibiotic in ≥ 3 antimicrobial categories [16]. Escherichia coli ATCC 25922 was used for quality control. Detection of ESBLs was performed by combined disc assay [15], using ceftazidime (30 μg) and cefotaxime (30 μg) discs, alone and in combination with clavulanic acid (10 μg). The production of ESBL was determined by the expansion of ≥ 5 mm of the zone diameters of combined discs compared to ceftazidime and cefotaxime zones.

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