ESBL Producers in Gram Negative Isolates from Clinical Samples

Mita D Wadekar,J.V Sathish,S Jayashree,C Pooja

doi:10.22207/jpam.14.3.42

Abstract

Resistance to beta lactam antibiotics is the most common cause for beta-lactamase production. Increasing number of extended spectrum beta-lactamase (ESBL) producers has reduced the treatment options which resulted in emergence of multidrug resistant strains, treatment failure and hence increased mortality. To detect phenotypically, ESBL producers in Gram negative isolates from different samples and to know their susceptibility pattern. A retrospective study of Gram negative isolates was conducted. Total of 521 isolates were isolated from various samples. They were processed and identified by standard procedures. The antibiotic susceptibility testing was performed by Kirby- Bauer disc diffusion method using CLSI guidelines. ESBL was detected by combination disk test. A total of 521 Gram negative isolates were isolated which included E. coli, Klebsiella pneumoniae, Citrobacter spp., Enterobacter spp., Proteus spp. and Acinetobacter spp. Pseudomonas aeruginosa. Of 521 isolates tested, ESBL was detected in 329 (63.1%) isolates. These isolates showed maximum susceptibility to piperacillin- tazobactam (86%) followed by imipenem (78.4%), amikacin (63.5%), cotrimoxazole (54.4%), ciprofloxacin (51%), amoxi-clav (44.9%), cefepime (44.1%), gentamicin (38.9%), cefoxitin (34.9%) and ampicillin (19.1%). ESBL producers which are resistant to beta lactam antibiotics have become a major problem. Detection of these beta-lactamase enzymes by simple disk method and its reporting will help clinicians in prescribing proper antibiotics.

Highlights

The increasing resistance of microorganisms to antimicrobials is posing the greatest threat to human health and is most challenging task to tackle it[1].Beta-lactam antibiotics are the one which are most frequently prescribed drug to treat any bacterial infections[2]
The antibiotic susceptibility testing was performed by Kirby- Bauer disc diffusion method using Clinical and Laboratory Standard Institute (CLSI) guidelines
extended spectrum beta-lactamase (ESBL) producers which are resistant to beta lactam antibiotics have become a major problem

Summary

Introduction

The increasing resistance of microorganisms to antimicrobials is posing the greatest threat to human health and is most challenging task to tackle it[1].Beta-lactam antibiotics are the one which are most frequently prescribed drug to treat any bacterial infections[2]. The main reason for increase in β-lactamases enzyme in bacteria is its widespread use and persistent exposure of β-lactam antibiotics which led to increase their spectrum of activity to include third generation cephalosporins and aztreonam. This is the reason for mutations in these enzymes and are called extended spectrum β-lactamases (ESBLs)[5]

Methods

Results

Conclusion