Detection of extended spectrum β-lactamase among gram negative clinical isolates from a tertiary care hospital in South India

Balan K

Abstract


Background: The β lactamase enzymes produced by the organisms break down the structural beta-lactam ring of β lactam antibiotics. Many genera of gram negative bacteria possess a naturally occurring, chromosomally mediated β lactamase and also some are plasmid mediated β lactamases. The objective of the study was to detect extended spectrum β lactamases among gram negative clinical isolates.

Methods: 200 clinical were subjected to routine disc diffusion technique and zone diameter of ≤27mm for Cefotaxime and ≤22mm for Ceftazidime or ≤25mm for Ceftriaxone were included in this study. The strains are subjected to double disc synergy test.

Results: Of 200 samples, 174 yielded organisms belonging to enterobacteriaceae and 26 yielded growth of nonfermenters. Out of 174 members of enterobacteriaceae family, 122 were E. coli, 36 Klebsiella spp, 8 Proteus spp, 5 Enterobacter spp and 3 Citrobacter spp. Out of 26 nonfermenters, 18 were Pseudomonas spp and 8 were Acinetobacter.

Conclusions: In the present study prevalence of ESBL was 23.3%, the high prevalence may be due to irrational use of third generation cephalosporins in both the hospital and community.


Keywords


Extended spectrum β lactamases, Cefotaxime, Ceftazidime, Double disc synergy test

Full Text:

PDF

References


Chaudhary U, Aggarwal R. Extended spectrum β-lactamases (ESBL) - an emerging threat to clinical therapeutics. Indian J Med Microbiol 2004;22:75-80.

Rodrigues C, Joshi P, Jani SH et al. Detection of β-lactamases in nosocomial gram negative clinical isolates. Indian J Med Microbiol 2004;22:247-50.

Subha A, Ananthan S. Extended spectrum β lactamase (ESBL) mediated resistance to third generation cephalosporins among Klebsiella pneumoniae in Chennai. Indian J Med Microbiol 2002;20:92-5.

Bomasang ES, Mendoza MT. Prevalence and risk factors associated with extended spectrum β lactamase among Enterobacteriaceae isolates at the Philippine general hospital. Phil J Microbiol Infect Dis 2003:32:151-8.

Khurana S, Taneja N, Sharma M. Extended Spectrum β lactamase mediated resistance in urinary tract isolates of family Enterobacteriaceae. Ind J Med Res 2002;116:145-9.

Kusum M, Wongwanich S, Dhiraputra C, Pongpech P, Naenna P. Occurrence of extended-spectrum beta-lactamase in clinical isolates of Klebsiella pneumoniae in a University Hospital, Thailand. J Med Assoc Thai 2004;87:1029-33.

Kumar CS, Neelagund YF. Extended spectrum of β lactamase mediated resistance to third generation Cephalosporins among Klebsiella pneumonia in neonatal Septicaemia. Indian Pediatr 2004;41:97-9.

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;22:172-4.

Shukla I, Tiwari R, Agrawal M. Prevalence of extended spectrum -lactamase producing klebsiella pneumoniae in a tertiary care hospital. Indian J Med Microbiol 2004;22:87-91.

Shivaprakasha, Radhakrishnan K, Gireesh AR. Routine screening for ESBL production, a necessity of today. Internet J Microbiol 2007;3:1.

Arunkumar G, Satyanarayana M, Shivananda PG. Detection of extended in a tertiary care centre (abstract). Proceedings of XXIII annual congress IAMM; 1999. p. 5.

Hansotia JB, Agarwal V, Pathak AA, Saoji AM. Extended spectrum beta-lactamase mediated resistance to third generation cephalosporins in Klebsiella pneumoniae in Nagpur, central India. Indian J Med Res 1997;105:158-61.