EXTENDED SPECTRUM BETA LACTAMASE PRODUCING UROPATHOGENS IN A TERTIARY CARE HOSPITAL IN SOUTH INDIA: A CLINICO MICROBIOLOGICAL STUDY

Author:

Muralidharan Vandhitha1,Jayachandran Abirami Lakshmy2,Kandasamy Balan3,J Balaji.4

Affiliation:

1. Nodal ofcer, Central virology lab Govt medical college Ramanathapuram Tamil nadu.

2. Associate professor Department of Microbiology Karpaga Vinayaga institute of medical sciences and Research center, Kanchipuram, Tamil nadu India.

3. Professor Department of Microbiology Karpaga Vinayaga institute of medical sciences and Research center, Kanchipuram, Tamil nadu India.

4. Reader Department of Prosthodontics Sri Venkateshwaraa Dental college,Ariyalur Puducherry India.

Abstract

Introduction: Urinary Tract Infection (UTI) is the most common bacterial infection encountered in both hospital and community setup and the presence of drug resistance carries remarkable clinical implication. Drug resistant phenotypes like ESBL (Extended Spectrum Beta lactamase producers) are difcult to treat causing increased morbidity. Aims: The present study aims to determine the prevalence of ESBL producing Enterobacteriacea among Uropathogens and to determine the Antibiotic susceptibility pattern. Materials and Methods :A total of 726 urine samples were obtained and processed as per standard microbiological techniques .Antibiotic susceptibility testing was done by Kirby Bauer disc diffusion method. All the isolates were screened for ESBL production and conrmed by Double Disc Synergy test (DDST).Differences between the antibiotic susceptibility pattern ,Various risk factors were assessed among the ESBL producing and non ESBLproducing bacteria and the signicance was analyzed . Statistical analysis used:Chi square test.(p < 0.05 signicant) Results: A total of 726 urine samples were processed of which 421 bacteria belonging to Enterobacteriaceae were included in the study. Most common organism isolated was Escherichia coli 279 (66.27%).Highest susceptibility was observed for Imipenem 361 (85.7%) and Amikacin 356 (84.5%).Out of 461 isolates, 235 (55.8%) isolates were positive for ESBL screening all the isolates were conrmed with DDST. There was a signicant difference for Diabetes mellitus, CAUTI and Inpatients among the antibiotic susceptibility pattern between ESBL and non ESBL producers.(p<0.0001) Conclusions: Early detection of Multidrug resistance isolates like ESBLproducers in routine testing could help avoid treatment failure. Screening for ESBL production needs to be carried out regularly in every clinical diagnostic laboratory to guide clinicians in proper selection of antibiotics. Continued monitoring of the susceptibility pattern of ESBLproducing bacteria will provide valuable information regarding the local antimicrobial susceptibility pattern which in turn will guide in choosing the initial empirical therapy

Publisher

World Wide Journals

Reference15 articles.

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2. Jain A, Roy I, Gupta MK, Kumar M, Agarwal SK . Prevalence of extended- spectrum beta-lactamase-producing Gram-negative bacteria in septicaemic neonates in a tertiary care hospital. J Med Microbiol . 2003;52:421-25

3. Mathur P, Kapil A, Das B, Dhawan B. Prevalence of extended spectrum beta lactamase producing gram negative bacteria in a tertiary care hospital. Indian J Med Res. 2002;115:153-57.

4. Krishnakumar S, Rajan RA, Babu MM, Bai VD:Antimicrobial susceptibility pattern of extended spectrum of beta lactamase (ESBL) producing uropathogens from pregnant women.India. J Med Healthcare.2012. 1:188-92.

5. Clinical Laboratory Standards Institute:Performance Standard for Antimicrobial Susceptibility Testing: 23rd Information Supplement. NCCLS Document M100-S26. Wayne, PA, USA, 2016.

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