Phenotypic Detection of Extended Spectrum β-lactamase Producing Gram Negative Bacteria Isolated From Clinical Specimens

Abstract

Background: Over the past decade, there has been a significant global rise in extended spectrum β-lactamase (ESBL) producing gram negative bacteria (GNB), posing a substantial concern. ESBLs, encoded by plasmids, are deemed threatening due to their ease of transmission between species. The Asia Pacific region has witnessed a surge in hospital-acquired infections attributed to ESBL-producing GNB, as highlighted by numerous studies. This study seeks to assess the prevalence of ESBL-producing GNB specifically within Nepal. Methods: This research, conducted at Grande International Hospital in Kathmandu, Nepal, adopted a descriptive cross-sectional approach. It spanned from July 2016 to February 2017 and encompassed patients receiving care at the hospital. The study involved the handling of samples directed to the Microbiology laboratory for Culture and sensitivity, as well as the identification of isolates and Antibiotic susceptibility testing, following established microbiological protocols. Screening for Multi-Drug resistance (MDR) and Extended Spectrum Beta-Lactamase (ESBL) was conducted for all Escherichia coli and Klebsiella pneumoniae isolates utilizing a combined Disk (CD) test method. Results: Out of 258 Escherichia coli and Klebsiella pneumoniae isolates, 42 isolates of E. coli and 21 isolates of K. pneumoniae were confirmed as ESBL producer. Conclusion: The regular surveillance of hospital-associated infections including monitoring of antimicrobial susceptibility pattern is needed for the formulation of a definite antimicrobial policy.