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Indian Journal of Microbiology Research


Burden of ESBL with antibiogram in clinical isolates of E.coli and Klebsiella species from tertiary care hospital in central India


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Author Details: Surender Kaur*,Abhijit Awari

Volume : 5

Issue : 4

Online ISSN : 2394-5478

Print ISSN : 2394-546X

Article First Page : 497

Article End Page : 503


Abstract

Introduction and Objectives: The ESBLs producing organisms are reported worldwide in increasing numbers for which Clinical Laboratory Standard Institute (CLSI) recommends screening for ESBLs producing Escherichia coli and Klebsiella species by phenotypic methods. The study was undertaken to assess the burden of ESBL and comparison of Double Disc Synergy Test (DDST) and Phenotypic Confirmatory Test (PCT) with gold standard E-Test for ESBL detection in clinical isolates of tertiary care hospital, Bhopal.
Materials and Methods: 223 clinical isolates of E.coli and Klebsiellae species were included in the study and those showing zone size of < 22>
Result: Out of 223 isolates 124 were potential ESBL producers with preponderance of E.coli 58.3%. E-Test showed confirmed cases of ESBL 72/124(58%) which was much higher than by DDST 44/124 (35.5%) but close to PCT 70/124 (56.4%) among suspected clinical isolates. Overall ESBL burden out of 223 isolates was 32.28% which is quite alarming. ESBL producing strain showed maximum sensitivity to Colistin, polymixin-B & Imipenem nearing 100% whereas sensitivity ranging from 60 to 85% for beta lactamase inhibitor combinations. Non-ESBL producers were more sensitive to Amikacin, Fluoroquinolones, Nitrofurantoin, Cotrimoxazole with sensitivity ranging between 40 to 70%.
Conclusion: With rise in ESBL producing strains with multi drug resistance, screening with Ceftazidime should be done to detect probable ESBL producer. PCT can be used with confidence with comparable results with that of MIC tests in resource poor microbiology laboratories which will save human, technical and monitory resources in terms of its confirmation by molecular genotypic methods.

Keywords: DDST-Double Disc Synergy Test, PCT-Phenotypic confirmatory test, E-Test-Epsilometer Test.

Doi :-https://doi.org/10.18231/2394-5478.2018.0101