A Study on Prevalence of Extended Spectrum Beta-lactamases Gene (CTX-M, TEM & SHV) Producing Enterobacteriaceae Members Isolated from Different Clinical Specimens at Tertiary Care Hospital, Uttarakhand

Abstract

Extended spectrum b-lactamases (ESBLs) are one of the major enzymes responsible for antimicrobial drug resistance in bacterial isolates. The objective of this study was to find out the ESBL genes (blaTEM, blaSHV and blaCTX-M) in Enterobacteriaceae. This study was conducted from November 2013 to October 2015. The identification of Enterobacteriaceae isolates & antimicrobial drug resistance was done by conventional standard microbial methods. Further genotypic detection of ESBL was done by multiplex PCR. Results: Among 942 Enterobacteriaceae isolates, 332 (35.24%) isolates was ESBL producers. We observed high prevalence of ESBL enzyme in Klebsiella pneumonia (59.09%). These isolate revealed high resistance to co-trimoxazole, fluoroquinolones and aminoglycosides. Out of 48 randomly selected isolates, ESBL genes were identified in 45 isolates which were found resistant to third generation cephalosporins. Single CTX-M gene noticed in 29 strains of Escherichia coli (E. coli), 02 strains of Klebsiella pneumoniae, and 01 strain of Proteus mirabilis. Occurrence of Combination of the genes e.g., (blaTEM+blaCTX-M), (blaSHV+blaCTX-M), (blaTEM+blaSHV+blaCTX-M) was detected in 08, 01 and 04 isolates respectively. Multiplex PCR in CTX-M carrying isolates revealed the presence of blaCTX-M group-1. The most common blaCTX-M group-1 was observed in all isolates of family Enterobacteriaceae. Antimicrobial drug resistance is a major problem of concern now a day. Studies like this will be helpful to knowing the burden of multi drug resistance as well as formulating antibiotics policy for a particular region.