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Background: Extended spectrum beta lactamases (ESBLs) and AmpC beta-lactamases Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â conferring resistance to expanded-spectrum cephalosporins, continue to be a major problem in health care settings.Knowlege of their occurrence is essential to guide the clinicians towards the appropriate anti-microbial treatment. The purpose of this study is to evaluate simultaneously the incidence of ESBL and AmpC Î²-lactamases, and to analyse their antibiotic susceptibility in nosocomial gram-negative clinical isolates from a tertiary care hospital. Material and Methods: A total number of 180 consecutive non repetitive clinical isolates of Escherichia coli (n=67), Klebsiella pneumoniae (n=9) ),P.aeruginosa (n=23), Proteus spp.(n=5),citrobacter spp. (n=3), Enterobacter spp.( n=2) and Acinetobacter spp.(n=13) obtained over a period of four monthsÂ (FebruaryÂ to May, 2011) , were screened for ESBL AmpC production by Kirby Bauer disk diffusion methodÂ and suspected isolates were subjected to double disk synergy, combined disk, MIC reduction and AmpC diskÂ tests for confirmation. Results: 37(20.55%) and 32(17.77%)Â were found to be ESBL andÂ AmpC producers from 80(44.44%) and 59 (32.77%) screened outÂ isolates respectively. Organismwise distribution of ESBL andÂ AmpC isolates showed E.coli (23.18% & 15.94%), Klebsiella spp (26.15% & 18.46), P.aeruginosa (17.39% & 13.04%) and Â Acinetobacter spp ( 0 & 46.15%) respectively and they wereÂ significantly multidrug resistance too. Conclusion: The incidence of ESBLsÂ and AmpC was found to be lower in our hospital. Both the double disk synergy and combined disk tests showed equal efficacy in screening of ESBLs and result emphasizesÂ the necessity of confirmation by MIC reduction test. Given the need for a test for AmpC ÃŸ-lactamases, the AmpC disk test could fill a current gap in diagnostic microbiology as it is reliable, simple and rapid.
Pathogenic Bacteria, Viral Disease