Scenario of Extended Spectrum Beta Lactamase (ESBL) producing Escherichia coli in a rural medical college of Himachal Pradesh

Abstract

Extended Spectrum Beta Lactamases (ESBLs) are beta-lactamases that hydrolyze extended-spectrum cephalosporins. They confer resistance to all β-lactam antibiotics with the exception of carbapenems. ESBL-producing organisms may appear susceptible to some extended-spectrum cephalosporins in routine antibiotic susceptibility testing. The detection of ESBL’s in 175 clinical isolates of Escherichia coli was done by a screening test, followed by comparison between two confirmatory tests i.e. double disc synergy test (DDST) and the Disc on disc (DOD) test. ESBL production was detected by DDST in 45% and by DOD in 23% of cases. The antibiotic susceptibility pattern by Kirby Bauer technique showed that 54% isolates were resistant to all the six first line antibiotics. Maximum drug resistance with ampicillin and no resistance with meropenem was seen. The results show that there is a high frequency of ESBL producing E.coli in our hospital . We recommend that an appropriate antibiotic policy should be framed in every hospital to check for indiscriminate use of drugs and that ESBL detection by DDST should be mandatory for every laboratory as it a easy and convenient way to detect drug resistance.