Prevalence, antibiotic resistance pattern and identification of extended spectrum beta-lactamase producing Klebsiella pneumoniae from urine samples in a tertiary care hospital

Abstract

the present study aim is to know the prevalence, Antibiotic resistance pattern and frequency of extended spectrum beta lactamases producing Klebsiella pneumonia in urine sample. Klebsiella species are important opportunistic nosocomial pathogens particularly Klebsiella pneumoniae which causes infections like septicemia, urinary tract infections, wound infections, pneumonia. Out of total bacterial nosocomial infections it is estimated that Klebsiella species causes 5-7% of infections. To control the spread of extended spectrum beta lactamases it is necessary to know the prevalence of these extended spectrum beta lactamases (ESBL) and to characterize their epidemiology. The present study is about ESBL producing Klebsiella pneumoniae which is diagnosed by phenotypic methods. Samples received in the Microbiology laboratory were processed following standard protocol. Total 227/3415 (6.6%) Klebsiella pneumoniae were isolated from urine sample among which number of ESBL producing isolates were 85/227. The isolates were tested by the Kirby-Bauer disc diffusion method on Muller Hinton agar (Hi-Media) using 0.5 McFarland’s as the turbidity standard as per CLSI guidelines. Klebsiella pneumoniae isolated were tested for ESBL production by CLSI recommended screening and confirmatory methods like phenotypic confirmation method and MIC using E test. It was noted that the prevalence of ESBL producing K. pneumoniae was fairly uniform during the study period. Maximum cases were seen in the age group of 31 – 40 years. The antibiotic resistance pattern of ESBL and non ESBL producing K. pneumoniae shows that all the ESBL producing Highly resistant drugs for Klebsiella pneumoniae ESBL isolates were Ampicillin (100%), Piperacillin (100%), Amoxycillin + clavulanic acid (66.0%). Non ESBL producing isolates were less resistant to the same antibiotics.