Extended spectrum beta-lactamase and AmpC producing Klebsiella pneumoniae: A therapeutic challenge

Abstract

Klebsiella pneumoniae accounts for substantial proportion of nosocomial infections. Increasing multidrug resistance of these bacteria is posing a great threat to hospitalized patients as it results into limitation of therapeutic options. Therefore, the present study was undertaken with the following Aim and Objective :To know the burden of extended spectrum beta lactamase (ESBL) producing K. pneumoniae and coexistence of AmpC in these isolates using phenotypic methods in a newly established teaching hospital in Punjab, India. Materials and Methods: ESBL and AmpC screening and confirmation was done using phenotypic methods as per the Clinical and Laboratory Standards Institute (CLSI) guidelines in 200 clinical isolates of K. pneumoniae . Results: Out of 200 isolates of K. pneumoniae , 116 (58%) were ESBL producer and 84 (42%) were ESBL nonproducer. Of these 116 ESBL-positive isolates, 29 (25%) were coproducer of AmpC beta-lactamase. ESBL producing isolates were significantly more resistant to other group of antibiotics as compared to ESBL nonproducers. Discussion: High prevalence rate of ESBL producing K. pneumoniae was observed in our institute. MDR in these isolates was frequent, indicating the extensive injudicious use of antibiotics. Conclusion: Increasing prevalence of ESBL producing K. pneumoniae need to be checked to reduce the mortality and morbidity due to the infections caused by these strains.