Extended Spectrum Beta - Lactamase Producing Escherichia coli at a Tertiary Care Hospital in Maharashtra, India: Phenotypic Detection and Antimicrobial Sensitivity Pattern.
Journal Title: INTERNATIONAL JOURNAL OF RECENT TRENDS IN SCIENCE AND TECHNOLOGY - Year 2011, Vol 1, Issue 2
Abstract
Extended spectrum beta lactamases (ESBLs) are rapidly evolving plasmid mediated; TEM and SHV derived enzymes, capable of hydrolyzing oxyimino-cephalosporins and monobactams. Bacteria producing ESBLs remain an important cause for failure of therapy with cephalosporins and other antibiotics. ESBL testing is useful for epidemiological or infection control purposes.Aims: The present study was conducted to detect ESBLs in strains of Escherichia coli isolated from various clinical samples in a tertiary care hospital. Material and Methods: A total of 272 non enteric randomly chosen non repetitive E.coli isolates obtained over the period of one year from both outpatient and hospitalized patients were studied. Out of 272 isolates, 191 (70.22%) were screened as ESBL producing. They were further studied for ESBL production by phenotypic confirmatory disc diffusion test (PCDDT). Results: It was observed that not all screen positive isolates were confirmed as ESBL producers. Of the total 191 ESBL positive isolates, the PCDDT method detected 168 (87.95%) cases. Overall prevalence of ESBL in E.coli was found to be 61.76%. Only 4 strains (1.47%) were found resistant to imipenem and 11 strains (4.04%) were found resistant to meropenem. Conclusions: The present study shows that any of the three screening agents can be used to detect potential ESBL producers. The routine antibiotic sensitivity test may fail to detect ESBL mediated resistance. Therefore, screening for detection of ESBL and confirmation of the same should be carried out by PCDDT method as it is simple, reproducible, cost effective and sensitive method. ESBL detection studies help to formulate an empirical antibiotic policy to treat Gram negative infections in respective hospitals.
Authors and Affiliations
N Suryawanshi, A Pichare, M Davane, K Deshpande
Keywords
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