Antibiotic susceptibility pattern of extended spectrum β-lactamase ESBL producing gram negative bacilli in a tertiary care teaching hospital, Bareilly, India

Authors

  • Anju Saxena Department of Pharmacology, T.S. Misra Medical College and Hospital, Amausi, Lucknow, Uttar Pradesh, India
  • Sujata Singh Department of Pharmacology, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, Uttar Pradesh, India
  • Rahul Goyal Department of Microbiology, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, Uttar Pradesh, India
  • Sumit Saxena Department of Community Medicine, T.S. Misra Medical College and Hospital, Amausi, Lucknow, Uttar Pradesh, India

DOI:

https://doi.org/10.18203/2319-2003.ijbcp20190139

Keywords:

Antimicrobial resistance, Colistin, ESBL, Imipenem

Abstract

Background: The increasing prevalence of infections caused by antibiotic-resistant bacteria makes empirical treatment of these infections difficult. Resistance to a wide variety of common antimicrobials has made the proliferation of extended spectrum β-lactamase (ESBL) producing strains a serious global health concern that has complicated treatment strategies and is very alarming. This study was undertaken to identify ESBL production in various gram negative bacilli isolated and to further study the antibiogram of ESBL producers and their contribution towards anti-microbial resistance.

Methods: A total of 2008 samples were taken and studied for positive bacterial growth. Presence of ESBL positivity was detected using Kirby-Bauer sensitivity testing method and their antibiogram was studied. Data was analysed using IBM SPSS version 20. Chi-square test was applied wherever applicable to check the significant difference among the different groups. p value of ≤0.05 was considered to be significant.

Results: A total of 2008 samples were studied. Out of which 655 gave positive bacterial growth and amongst these 312 were ESBL producers. Resistance to multiple classes of antibiotics was observed among ESBL producers and mostly imipenem, colistin and polymyxin B were the antibiotics which were sensitive to most of the strains.

Conclusions: The frequency of ESBL producing strains among clinical isolates has been steadily increasing. Advance drug resistance surveillance and development of newer antibiotics is necessary to guide the appropriate and judicious antibiotic use.

References

Bradford PA. Extended-spectrum β-lactamases in the 21st century: characterization, epidemiology, and detection of this important resistance threat. Clin Microbiol Rev. 2001 Oct 1;14(4):933-51.

Giraud-Morin C, Fosse T. A seven-year survey of Klebsiella pneumoniae producing TEM-24 extended-spectrum β-lactamase in Nice University Hospital (1994-2000). J Hospital Infection. 2003 May 1;54(1):25-31.

Gupta V. An update on newer beta-lactamases. Indian J Med Res. 2007 Nov 1;126(5):417-27.

Livermore DM, Canton R, Gniadkowski M, Nordmann P, Rossolini GM, Arlet G, et al. CTX-M: changing the face of ESBLs in Europe. J Antimicrob Chemotherapy. 2007 Feb 1;59(2):165-74.

Stürenburg E, Mack D. Extended-spectrum β-lactamases: implications for the clinical microbiology laboratory, therapy, and infection control. J Infection. 2003 Nov 1;47(4):273-95.

Perez F, Endimiani A, Hujer KM, Bonomo RA. The continuing challenge of ESBLs. Current Opin Pharmacol. 2007 Oct 1;7(5):459-69.

Romero ED, Padilla TP, Hernández AH, Grande RP, Vázquez MF, García IG, et al. Prevalence of clinical isolates of Escherichia coli and Klebsiella spp. producing multiple extended-spectrum β-lactamases. Diagnostic Microbiol Infect Dis. 2007 Dec 1;59(4):433-7.

Kuo K, Shen Y, Hwang K. Clinical implications and risk factors of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae infection in children: a case-control retrospective study in a medical center in southern Taiwan. J Microbiol Immunol Infection. 2007 Jun;40(3):248-54.

Hosoglu S, Gundes S, Kolayli F, Karadenizli A, Demirdag K, Gunaydin M, et al. Extended-spectrum beta-lactamases in ceftazidime-resistant Escherichia coli and Klebsiella pneumoniae isolates in Turkish hospitals. Indian J Med Microbiol. 2007 Oct 1;25(4):346-50.

Messai Y, Iabadene H, Benhassine T, Alouache S, Tazir M, Gautier V, et al. Prevalence and characterization of extended-spectrum β-lactamases in Klebsiella pneumoniae in Algiers hospitals (Algeria). Patholog Biol. 2008 Jul 1;56(5):319-25.

Jacoby GA, Munoz-Price LS. The new β-lactamases. N Eng J Med. 2005 Jan 27;352(4):380-91.

Clinical Laboratory Standards Institute CLSI. Performance standards for antimicrobial susceptibility testing in Proceedings of the 16th International Supplement (M100-S16), National Committee for Clinical Laboratory Standards, Wayne, Pa, USA, 2006.

Chopra I, Schofield C, Everett M, O'Neill A, Miller K, Wilcox M, et al. Treatment of health-care-associated infections caused by Gram-negative bacteria: a consensus statement. Lancet Infectious Dis. 2008 Feb 1;8(2):133-9.

Morosini MI, García-Castillo M, Coque TM, Valverde A, Novais A, Loza E, et al. Antibiotic coresistance in extended-spectrum-β-lactamase-producing enterobacteriaceae and in vitro activity of tigecycline. Antimicrob Agents Chemotherapy. 2006 Aug 1;50(8):2695-9.

Pitout JD, Laupland KB. Extended-spectrum β-lactamase-producing Enterobacteriaceae: an emerging public-health concern. Lancet Infectious Dis. 2008 Mar 1;8(3):159-66.

Talbot GH. What is in the pipeline for Gram-negative pathogens?. Expert Rev Anti Infect Ther. 2008 Feb;6(1):39-49.

Canton R, Novais A, Valverde A, Machado E, Peixe L, Baquero F, Coque TM. Prevalence and spread of extended‐spectrum β‐lactamase‐producing Enterobacteriaceae in Europe. Clin Microb Infection. 2008 Jan;14:144-53.

Narayanaswamy A, Mallika M. Prevalence of extended spectrum beta lactamases in urinary isolates of Escherichia coli in a tertiary care hospital, Chennai, South India. Intl J Med 2011;6 Narayanaswamy A, Mallika M. Prevalence and Susceptibility of extended spectrum beta-lactamases in urinary isolates of Escherichia coli in a Tertiary Care Hospital, Chennai-South India. Internet J Medi Update. 2011;6(1):39-43.

Dalela G, Gupta S, Jain DK, Mehta P. Antibiotic resistance pattern in uropathogens at a tertiary care hospital at Jhalawar with special reference to ESBL, AmpC β- lactamases and MRSA production. J Clin Diagn Res. 2012;6:645-51.

Jobayer M, Afroz Z, Nahar SS, Begum A, Begum SA, Shamsuzzaman SM. Antimicrobial susceptibility pattern of extended-spectrum beta-lactamases producing organisms isolated in a Tertiary Care Hospital, Bangladesh. Int J Applied Basic Med Res. 2017 Jul;7(3):189-92.

Maya AS, Prabhakar K, Hanna LE, Sarayu YL. Phenotypic and genotypic characterization of extended-spectrum beta-lactamase producing Escherichia coli clinical isolates from semi urban area. J Pharm Res. 2011;4:6-10.

Soltani R, Ehsanpoor M, Shokri D. Antimicrobial susceptibility pattern of extended-spectrum β-lactamase-producing bacteria causing nosocomial urinary tract infections in an Iranian referral teaching hospital. J Res Pharm Pract.2014;3(1):6-11.

Krishnakumar S, Rajan RA, Babu MM, Bai VD. Antimicrobial susceptibility pattern of extended spectrum of beta lactamase (ESBL) producing uropathogens from pregnant women. Indian J Med Healthcare. 2012 Nov 1;1(8):189-92.

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 Jul 1;22(3):172.

Mathur P, Kapil A, Das B, Dhawan B. Prevalence of extended spectrum β- lactamase producing Gram negative bacteria in tertiary care hosptital. Indian J Med Res. 2002;115:153-7.

Gales A, Sader H, Jones R, SENTRY participants group (Latin America). Urinary tract infection’s trends in the American hospitals: reports from the SENTRY Antimicrobial Surveillance programme (1997- 2000). Diagn Microbial Infect Dis 2002;44:289-99.

Aruna K, Mobashshera T. Prevalence of extended spectrum beta-lactamase production among uropathogens in South Mumbai and its antibiogram pattern. EXCLI J. 2012 Jul 6;11:363-72.

Mansury D, Motamedifar M, Sarvari J, Shirazi B, Khaledi A. Antibiotic susceptibility pattern and identification of extended spectrum β-lactamases (ESBLs) in clinical isolates of Klebsiella pneumoniae from Shiraz, Iran. Iranian J Microbiol. 2016 Feb;8(1):55.

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 Oct;7(10):2173.

Gupta V. An update on newer beta-lactamases. Indian J Med Res. 2007 Nov 1;126(5):417-27.

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Published

2019-01-24

How to Cite

Saxena, A., Singh, S., Goyal, R., & Saxena, S. (2019). Antibiotic susceptibility pattern of extended spectrum β-lactamase ESBL producing gram negative bacilli in a tertiary care teaching hospital, Bareilly, India. International Journal of Basic & Clinical Pharmacology, 8(2), 228–233. https://doi.org/10.18203/2319-2003.ijbcp20190139

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Original Research Articles