Author(s): UMADEVI S, KANDHAKUMARI G, JOSEPH N M, KUMAR S, EASOW J M
The production of extended-spectrum- β lactamases (ESBLs) is an important mechanism for resistance to the third-generation cephalosporins. Awareness and the detection of these enzymes are necessary for optimal patient care. To determine the prevalence and the antibiotic sensitivity pattern of ESBL producing gram negative bacilli. A prospective study was conducted at a tertiary care teaching hospital A total of 213 isolates which were recovered between February 2008 and January2009 from various samples were tested for ESBL production by using both the double-disk approximation and the combination disk methods. Among the 132 Escherichia coli, 54 Klebsiella pneumoniae and 27 Pseudomonas isolates which were tested, 81%, 74%, and 14%, respectively were found to be ESBL producers. The ESBL producing E. coli showed maximum susceptibility to imipenem (100%), followed by piperacillin-tazobactum (84%), amikacin (68%), gentamicin (9%), ciprofloxacin (9%) and amoxicillin-clavulanic acid (7%). Similarly, the ESBL producing K. pneumoniae showed very good susceptibility to imipenem (98%), followed by piperacillin-tazobactum (68%), amikacin (40%), gentamicin (15%), ciprofloxacin (15%) and amoxicillin-clavulanic acid (5%). About 87% and 88% of the ESBL producing E. coli and K. pneumoniae respectively showed multi-drug resistance to amoxicillin-clavulanic acid, gentamicin and ciprofloxacin. It is essential to report ESBL production along with the routine sensitivity reporting, which will help the clinician in prescribing the proper antibiotics. Piperacillin-tazobactam and imipenem are the most active and reliable agents for the treatment of infections which are caused by ESBL producing organisms.