PREVALENCE AND ANTIMICROBIAL SUSCEPTIBILITY PATTERN OF EXTENDED SPECTRUM ?-LACTAMASE (ESBL) PRODUCING GRAM NEGATIVE BACILLI (KLEBSIELLA PNEUMONIA) IN A TERTIARY CARE TEACHING HOSPITAL, IN SOUTHERN-WEST KOTA DISTRICT OF RAJASTHAN (INDIA).

Abstract

Background and Objectives: The resistance to broad spectrum ?-lactams which is mediated by the extended spectrum beta lactamase (ESBL) enzyme is an increasing problem now-a-days. This resistance mechanism has been responsible for nosocomial outbreaks, serious therapeutic failure if it is not detected on time and the outbreak of multidrug resistant, gram negative pathogens that need expensive control measures.

Aim: To know the prevalence of ESBL production in klebsiella pneumoniae and antibiotic sensitivity pattern to 3^rd generation of cephalosporins in Govt. Medical College Kota.

Material and Methods: The study was conducted in Department of Microbiology, Kota Medical College, Kota, Rajasthan, from dec.2018 to dec.2019. Due permission from institutional ethical committee was obtained. This is descriptive observational study. All data were collected and analyzed with the help of suitable statistical parameters.

A total of 101 consecutive, nonrepetitive, gram negative isolates, which were resistant to one of the third generation cephalosporins (cefotaxime,ceftriaxone or ceftazidime) were selected as “Suspicious for ESBL production” as recommended by the Clinical and Laboratory Standards Institute (CLSI). These isolates were confirmed for ESBL production by the double disc synergy test (DDST) and the phenotypic confirmatory disc diffusion test (PCDDT) and they were further confirmed by the E-test ESBL strip randomly.

 Result: Out of the 101 isolates by double disc synergy test (DDST) 45.54% (46) of Klebsiella pneumoniae isolates were ESBL producers, while PCDDT detected 58.41% (59) Klebsiella pneumoniae isolates as ESBL producers (p value<0.05). Randomly selected isolates were further confirmed by the E-test ESBL strip, which showed a highly significant correlation with PCDDT.

Key words: Antimicrobial Susceptibility, Klebsiella pneumoniae, Gram Negative bacilli, Cephalosporins