PREVALENCE AND ANTIMICROBIAL SUSCEPTIBILITY OF URINARY TRACT INFECTION CASES AND FINDING OF ESBL AND AMPC β-LACTAMASES PRODUCING ESCHERICHIA COLI AND KLEBSIELLA PNEUMONIAE IN A TERTIARY CARE HOSPITAL MIZORAM

Abstract

Introduction: Resistance to broad spectrum -lactams mediated by extended spectrum -lactamases (ESBL) and AmpC -lactamases enzymes is a growing threat worldwide.Aim: The aim of the study was to detect the prevalence and antimicrobial susceptibility of ESBL and AmpC -lactamase producing Escherichia coli and Klebsiellapneumoniae isolated from Urinary Tract infection Materials and Methods: A total of 288 isolates comprising of 180 Escherichia coli and 108 Klebsiellapneumoniaeisolated from various clinical samples were included. ESBL was detected by Phenotypic Conrmatory Disc Diffusion Test (PCDDT) and Double Disk Synergy Test (DDST). AmpC detection was done by AmpC disk test. Results: Out of 180 Escherichia coli, and 108 Klebsiellapneumoniaeisolates 91(50.5%) and 63(58.3%) were conrmed to be ESBL producers by PCDDT and 81(45%) and 57(52.7%) by DDST respectively. AmpC was detected in 35(19.4%) of Escherichia coli and 33(30.5%) of Klebsiellapneumoniae isolates. Co-production of ESBL and AmpC was detected in 6(3.3%) Escherichia coli and 11(10.18%) of Klebsiellapneumonia isolates. Majority of ESBL producers were from blood in both organisms. Multi drug resistance (MDR) was seen in 79.1% of ESBLEscherichiacoli and 63.5% of ESBLKlebsiellapneumoniae isolates. MDR was seen in 28(96.5%) of AmpC producing Escherichia coli and all AmpC producing Klebsiellapneumoniae isolates. Conclusion: It is essential to report ESBL and AmpC beta lactamase production along with routine susceptibility which will aid the clinicians in prescribing antibiotics.Strict adherence to the hospital antibiotic policy and good infection control practices would go a long way in curtailing the menace of drug resistance.