Extended spectrum β-lactamases in urinary isolates of Escherichia coli - prevalence and susceptibility pattern at a tertiary care hospital

Authors

  • Sapna Chauhan Department of Microbiology, Shri Guru Ram Rai Institute of Health and Medical sciences, Dehradun, Uttarakhand
  • Bhim Singh Mahawal Department of Microbiology, Shri Guru Ram Rai Institute of Health and Medical sciences, Dehradun, Uttarakhand
  • Durgesh Chand Ramola Department of Microbiology, SGRRIM & HS, Dehradun, U.A.

DOI:

https://doi.org/10.18203/2320-6012.ijrms20150240

Keywords:

ESBL, Escherichia coli, Double-disk approximation test, Multi-drug resistance, Prevalence

Abstract

Introduction: Urinary Tract infections caused by Escherichia coli have become a significant global public health problem. The resistance to β- lactam antibiotics in these clinically important gram negative bacteria further adds to the problem. Knowledge about their prevalence is essential to guide towards appropriate antibiotic treatment. The study was thus undertaken to know prevalence and susceptibility pattern of Extended spectrum β - lactamase (ESBL) producing Escherichia coli isolates among urinary samples.

Methods: A total of 216 E. coli isolates in urinary samples were studied for ESBL production by using CLSI Phenotypic screening and confirmatory tests.

Results: 53% of E.coli isolates were ESBL producers. The susceptibility of ESBL producers to Imipenem, Tigecycline and Nitrofurantion was found to be 100%, 100% and 88% respectively. A high degree of associated resistance to Amikacin, Co-trimoxazole and Quinolones was found in ESBL producers. Majority of ESBL producers were detected among patients admitted in various ICUs and surgery ward.

Conclusion: Our study shows presence of ESBL producer E.coli in large number of urinary isolates.

References

Ronald AR, Nicolle LE, Stamm E. Urinary tract infection in adults: research priorities and strategies. Int J Antimicrob Agents. 2001;17:343-8.

Van Eldere J. Multicentre surveillance of Pseudomonas aeruginosa susceptibility patterns in nosocomial infections. J Antimicrob Chemother. 2003;51(2):347-52.

Miranda S, Davide M, Peter J. Evolution of multi-resistance plasmids in Australia clinical isolates of Escherichia coli. Microbiology. 2004;150:1539-46.

Bush K, Jacoby GA, Medeiros AA. A functional classification scheme for β-lactamases and its correlation with molecular structure. Antimicrob Agents Chemother. 1995;39:1211-33.

Jarlier et al. Indian J Med Res 2008;127:85-8 .

Bal S. Beta-lactamase mediated resistance in hospital-acquired Urinary Tract Infections. Hospital today. 2000;5:96-101.

Mena A, Plasencia V, Carcia L, Hidalgo O, Ayestaran JI, Alberti S et al. Characterisation of a large outbreak by CTX-M-1 producing Klebsiella pneumonia and mechanisms leading to in vivo carbapenem resistance development. J Clin Microbiol. 2006;44:8:2831-7.

Clinical and Laboratory Standards Institute. Performance standard for antimicrobial susceptibility testing. 22nd informational supplement, 2012;32:M100-S22.

National Committee for Clinical Laboratory Standards. Performance standards for antimicrobial disk susceptibility test, 7th edition. approved standards, NCCLS Document M2-A7,Vol. 20(1): Wayne PA, 2000. Dis. 1988;10:867- 78.

Hawser SP, Bouchillon SK, Hoban DJ, Badal RE, Hsueh P-R, Paterson DL. Emergence of High Levels of Extended-Spectrum-{beta}-Lactamase-Producing Gram-Negative Bacilli in the Asia-Pacific Region: Data from the Study for Monitoring Antimicrobial Resistance Trends (SMART) Program, 2007. Antimicrob Agents Chemother. 2009;53(8):3280-4.

Bajpai T, Pandey M, Varma M, Bhatambare G. Prevalence of extended spectrum beta-lactamase producing uropathogens and their antibiotic resistance profile in patients visiting a tertiary care hospital in central India: Implications on empiric therapy. Indian J Pathol Microbiol. 2014;57(3):407-12.

Sharma M, Pathak S, Srivastava P. Prevalence and antibiogram of extended spectrum β-lactamase (ESBL) producing Gram negative bacilli and further molecular characterization of ESBL producing Escherichia coli and klebsiella spp. J Clin Diag Res. 2013;7(10):2173-77.

Mohamudha PR, Harish BN, Parija SC. Molecular description of plasmid-mediated AmpC beta-lactamases among nosocomial isolates of Escherichia coli & Klebsiella pneumoniae from six different hospitals in India. Indian J Med Res. 2012;135:114-9.

Manoharan A, Premalatha K, Chatterjee S, Mathai D. Correlation of TEM, SHV and CTX-M extended-spectrum beta lactamases among Enterobacteriaceae with their in vitro antimicrobial susceptibility. Indian J Med Microbiol. 2011;29(2):161-4.

Shoorashetty RM, Nagarathnamma T, Prathibha J. Comparison of the boronic acid disk potentiation test and cefepime-clavulanic acid method for the detection of ESBL among AmpC-producing Enterobacteriaceae. Indian J Med Microbiol. 2011;29(3):297-301.

Sridhar Rao P, Basavarajappa K, Krishna G. Detection of extended spectrum beta-lactamase from clinical isolates in Davangere. Indian J Pathol Microbiol. 2008;51(4):497-9.

Varaiya A, Dogra J, Kulkarni M, Bhalekar P. Extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae in diabetic foot infections. Indian J Pathol Microbiol. 2008;51(3):370-2.

Wani K, Thakur M, Siraj FA, Fomdia B, Gulnaz B, Maroof P. Extended Spectrum -Lactamase Mediated Resistance in Escherichia Coli in a Tertiary Care. International J Health Sci. 2009;3(2):155-63.

Goyal A, Prasad K, Prasad A, Gupta S, Ghoshal U, Ayyagari A. Extended spectrum beta-lactamases in Escherichia coli & Klebsiella pneumoniae & associated risk factors. Indian J Med Res. 2009;129(6):695-700.

Tsering D, Das S, Adhiakari L, Pal R, Singh T. Extended spectrum beta-lactamase detection in gram-negative bacilli of nosocomial origin. J Glob Infect Dis. 2009;1(2):87-92.

Agrawal P, Ghosh A, Kumar S, Basu B, Kapila K. Prevalence of extended-spectrum b-lactamases among Escherichia coli and Klebsiella pneumoniae isolates in a tertiary care hospital. Indian J Pathol Microbiol. 2008;51(1):139-42.

Gupta V. Detection of ESBLs using third and fourth generation cephalosporins in double disc synergy test. Indian J Med Res. 2007;126:486-7.

Kumar M, lakshmi V, Rajagopalan R. Occurrence

of extended spectrum beta-lactamases among Enterobacteriaceae spp. isolated at a tertiary care institute. Indian J Med Microbiol. 2006;24(3):208-11.

Babypadmini S, Appalaraju B. Extended spectrum -lactamases in urinary isolates of Escherichia coli and Klebsiella pneumoniae - prevalence and susceptibility pattern in a tertiary care hospital. Indian J Med Microbiol. 2004;22(3):172-4.

Manchanda V, Singh NP. Occurrence and detection of AmpC {beta}-lactamases among Gram-negative clinical isolates using a modified three-dimensional test at Guru Tegh Bahadur Hospital, Delhi, India. J Antimicrob Chemother. 2003;51(2):415-8.

Paterson DL, Bonomo RA. Extended-spectrum beta-lactamases: a clinical update. Clin Microbiol Rev. 2005;18(4):657-86.

Mohanty S, Singhal R, Sood S, Dhawan B, Das B, Kapil A. Comparative in vitro activity of beta-lactam/beta-lactamase inhibitor combinations against gram negative bacteria. Indian J Med Res. 2005;122(5):425-8.

Sarma JB, Bhattacharya PK, Kalita D, Rajbangshi M. Multidrug-resistant Enterobacteriaceae including metallo-beta-lactamase producers are predominant pathogens of healthcare-associated infections in an Indian teaching hospital. Indian J Med Microbiol. 2011;29(1):22-7.

Jones RN, Pfaller MA. Antimicrobial activity against strains of Escherichia coli and Klebsiella spp. with resistance phenotypes consistent with an extended-spectrum β-lactamase in Europe. Clinical Microbiology and Infection. 2003;9(7):708-12.

Khanduri A, Thakuria B, Gupta P. Effectiveness of Combination Drugs In Extended Spectrum Beta Lactamases Producing Gram Negative Isolates- Experience In A Tertiary Care Hospital of Uttarakhand. Int J Pharm Bio Sci. 2012;3(3):251-60.

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Published

2017-01-10

How to Cite

Chauhan, S., Mahawal, B. S., & Ramola, D. C. (2017). Extended spectrum β-lactamases in urinary isolates of Escherichia coli - prevalence and susceptibility pattern at a tertiary care hospital. International Journal of Research in Medical Sciences, 3(7), 1622–1626. https://doi.org/10.18203/2320-6012.ijrms20150240

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Original Research Articles