Phenotypic identification of extended spectrum beta lactamase, metallo beta lactamase, Amp-C and biofilm producing E.coliand Klebsiellafrom clinical isolates

Abstract

Introduction and Aim: E. coliandKlebsiellapose a major problem not only in the hospital settings but also in the community as they have acquired various resistance mechanisms to multiple antibiotics due to extensive use of the beta-lactam group. They are also the most common organisms implicated to produce biofilm on biomedical devices. The aim of the study was to detect the antibiotic resistance betweenE. coliandKlebsiellaproducing ESBL, MBL, AmpC by using phenotypic methods and their implication in biofilm formation. Material and Methods: Nearly, 100 clinical isolates ofE. coliandKlebsiellafrom various clinical specimens were received from tertiary care hospital to the Microbiology laboratory, during the period of February to May 2014. These samples were processed, and standard antibiotic sensitivity was done as per CLSI guidelines. ESBL, MBL, AmpC, and Biofilm producers were identified by double-disc, disc combination method, AmpC disc method, and micro titerplate method respectively. Results: Out of 100 isolates 55(55%) wereE. coliand 45(45%) wereKlebsiella. Out of 55E. coliisolates, 22(12%) were ESBL, 12(6%) MBL, and 6(3%) AmpC producers, 15(8%) isolates showed no reaction. Out of 45Klebsiella, 14(6%) were ESBL, 12(5%) were MBL and 12(5%) were AmpC producers, 7(3%) isolates showed no reaction. We observed that 6 (3%)E. coliand 8(4%)Klebsiellaproduced biofilm. Conclusion: Failure to detect ESBL, MBL, and AmpC producingE. coliandKlebsiellaspp result in the uncontrolled spread and therapeutic failure. Biofilm formation results in chronic bacterial infections. The above-mentioned phenotypic methods can be used to detect different beta-lactamase enzymes in resource-limited settings,as they are simple, rapid, and technically fewer demanding methods. Keywords: ESBL; MBL; AmpC;Escherichia coli; Klebsiella pneumoniae.