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Indian Journal of Microbiology Research


Phenotypic prevalence of Extended Spectrum Beta-Lactamase (ESBL) producing Enterobacteriaceae and antibiotic coresistance in a tertiary care hospital


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Author Details: Garima, Deepti Chaurasia

Volume : 4

Issue : 1

Online ISSN : 2394-5478

Print ISSN : 2394-546X

Article First Page : 90

Article End Page : 95


Abstract

Introduction: The multidrug resistant Enterobacteriaceae isolates pose not only therapeutic problems but also serious concerns for infection control management. Early detection of lactamase producers is crucial to establish appropriate antimicrobial therapy and to prevent their interhospital and intrahospital dissemination.
Objective: To study the prevalence of ESBL producing bacteria among all the members of Enterobacteriaceae isolated from various clinical specimens collected from all wards across a tertiary care teaching hospital.
Methodology: ESBL production was detected among all the Enterobacteriaceae using, Phenotypic Combined Disk Diffusion Test (PCDDT), as recommended by the Clinical Laboratory Standards Institute (CLSI).
Results: There is a high prevalence (25.67%) of ESBL producers in our hospital and so, it is essential to report the ESBL production along with the routine sensitivity reports, which will help the clinician in prescribing proper antibiotics. Pediatric ward had the highest number of ESBL positive Blood cultures. The pus isolates culture sensitivity testing from Surgery ward, Orthopedics and Burn and Plastic Surgery ward showed maximum number of ESBL strains. ESBL isolates show coresistance to many other classes of antimicrobials. Carbapenems (Imipenem, Meropenem), BL/BLI combination viz. Cefoperazone-sulbactum and aminoglycoside (amikacin) came out to be effective against these.
Conclusion: A high degree of ESBL producers and carbapenem resistant Enterobacteriaceae is concerning; with emerging resistance to colistin, raising the fear of a return to the preantibiotic era. An urgent intervention including creating awareness and establishment of robust infection control and antibiotic stewardship program is the most important need of the hour.

Keywords:
ESBL, Coresistance, Antimicrobial Susceptibility, Gram negative Bacilli, Nosocomial