Prevalence and antibiogram of extended spectrum β- lactamase producing Klebsiella pneumoniae in a tertiary care hospital

Abstract

Resistant Extended spectrum β lactamases (ESBL) bacteria are emerging worldwide as a threat to favorable outcome in the treatment of common infections in community and hospital settings. They are mainly found in Escherichia coli, Klebsiella species and Proteus species. Extensive and often indiscriminate use of the extended-spectrum cephalosporins in particular, Ceftazidime, Cefotaxime and Ceftriaxone, is associated with the emergence and spread of multi drug resistant K. pneumoniae. Prevalence of ESBLs varies from institute to institute. Hence the present study was done to know the prevalence and antibiogram of ESBL producing K. pneumoniae. This was a prospective study conducted in a tertiary care hospital in South India from April 2011 to May 2012. Consecutive non-repeat culture isolates of were obtained from different clinical specimens such as urine, pus, blood etc. Antimicrobial susceptibility was determined by Kirby-Bauer disk diffusion method as per CLSI recommendations. Higher resistance among ESBL producers than among non-ESBL producers. Highest resistance was seen with beta lactam antibiotics, Gentamicin and Ciprofloxacin. Resistance to Aztreonam was zero percent and one isolate was resistant to Imipenem. During the past decade, ESBL producing Gram-negative bacilli especially Escherichia coli and K. pneumoniae have emerged as serious pathogens both in hospital and community acquired infections worldwide. An important step in rationalizing the use of antibiotics is the formulation of hospital infection control committee. Antibiotic policy should be prepared in consultation with various clinical and surgical clinical departments. Routine detection of ESBL-producing microorganisms should be done by each laboratory, which helps physicians in choosing an appropriate empirical therapy and conserve powerful antibiotics for life threatening infections.