alexa Abstract | Surveillance on Extended Spectrum β-lactamase and AmpC β-lactamase producing gram negative isolates from nosocomial infections

Archives of Clinical Microbiology
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Abstract

Background: Extended spectrum beta lactamases (ESBLs) and AmpC beta-lactamases                   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 β-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 months  (February  to May, 2011) , were screened for ESBL AmpC production by Kirby Bauer disk diffusion method  and suspected isolates were subjected to double disk synergy, combined disk, MIC reduction and AmpC disk  tests for confirmation. Results: 37(20.55%) and 32(17.77%)  were found to be ESBL and  AmpC producers from 80(44.44%) and 59 (32.77%) screened out  isolates respectively. Organismwise distribution of ESBL and  AmpC isolates showed E.coli (23.18% & 15.94%), Klebsiella spp (26.15% & 18.46), P.aeruginosa (17.39% & 13.04%) and  Acinetobacter spp ( 0 & 46.15%) respectively and they were  significantly multidrug resistance too. Conclusion: The incidence of ESBLs  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 emphasizes  the necessity of confirmation by MIC reduction test. Given the need for a test for AmpC ß-lactamases, the AmpC disk test could fill a current gap in diagnostic microbiology as it is reliable, simple and rapid.

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Author(s): RKManojkumar Singh Nishith Kumar Pal Mandira Banerjee Soma Sarkar Manideepa SenGupta

Keywords

Pathogenic Bacteria, Viral Disease

 
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