Therapeutic options for extended-spectrum β-lactamases (ESBLs), AmpC β-lactamases producing Escherichia coli and Klebsiella sp. isolated from various clinical samples

Vimal Kumar, Narinder Kaur, S. Chauhan, R. Bala, J. Chauhan, Harit Kumar, Shivani Devi
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Abstract

Escherichia coli and Klebsiella sp. are the predominant species isolated from clinical samples. Recent and proper understanding of the antibiotic susceptibility pattern of extended-spectrum β-lactamases (ESBL) and AmpC β-lactamases (AmpC) producing E. coli and Klebsiella sp. will prevent the distribution and future incidence of ESBL and AmpC. We designed this study to understand antibiotic susceptibility patterns of ESBL and AmpC producing E. coli and Klebsiella sp. isolated from a tertiary care hospital in North India. A cross-sectional study was conducted from March 2021 to February 2022. Guring this period, various clinical samples were collected and further tested for ESBL producing E. coli and Klebsiella sp. by using the Double disc Synergy test, whereas AmpC was detected by the Boronic acid disk potentiation method. Their antibiotic susceptibility patterns were noted. Various clinical specimens were collected, in which 37.95% were shown growth of bacteria. Among them, 46.67% of E. coli and 25.21% of Klebsiella sp. were identified by standard laboratory protocol. ESBL producing isolates were 44.37% and 34.20% in E. coli and Klebsiella sp., respectively. Whereas AmpC production was detected in 18.27% of E. coli and 29.36% of Klebsiella sp. ESBL and AmpC producing E. coli and Klebsiella sp. isolated from pus, blood, and sputum samples showed the highest sensitivity towards colistin, tigecycline, and imipenem while in urine samples imipenem, meropenem showed the highest sensitivity. Susceptibility patterns of ESBL and AmpC producing E. coli and Klebsiella sp. from various clinical specimens enhance hospital infection management and help clinicians to prescribe the appropriate antibiotics. The carbapenem, nitrofurantoin, colistin and tigecycline were showed highest susceptible against ESBL and AmpC producing E. coli and Klebsiella sp.
广谱β-内酰胺酶(ESBLs)的治疗选择,AmpC β-内酰胺酶产生大肠杆菌和克雷伯氏菌,从各种临床样品分离
大肠杆菌和克雷伯氏杆菌是临床样本中分离到的优势菌种。近期正确认识产生大肠杆菌和克雷伯氏菌的广谱β-内酰胺酶(ESBL)和AmpC β-内酰胺酶(AmpC)的药敏模式,将有助于预防ESBL和AmpC的分布和未来的发病率。我们设计这项研究是为了了解从北印度一家三级保健医院分离的产ESBL和AmpC的大肠杆菌和克雷伯氏菌的抗生素敏感性模式。一项横断面研究于2021年3月至2022年2月进行。在此期间,收集各种临床样本,采用双盘协同法检测产生ESBL的大肠杆菌和克雷伯氏菌,采用硼酸盘增强法检测AmpC。记录了他们的抗生素敏感性模式。采集各种临床标本,37.95%的标本中有细菌生长。其中大肠杆菌阳性率46.67%,克雷伯氏菌阳性率25.21%。大肠杆菌和克雷伯氏菌产生ESBL的分离株分别为44.37%和34.20%。而产AmpC的大肠杆菌和克雷伯氏菌分别在18.27%和29.36%中检测到。产AmpC的大肠杆菌和克雷伯氏菌在脓、血和痰中对粘菌素、替加环素和亚胺培南最敏感,而在尿中对亚胺培南和美罗培南最敏感。不同临床标本中产生ESBL和AmpC的大肠杆菌和克雷伯氏菌的药敏模式可加强医院感染管理,帮助临床医生处方适当的抗生素。碳青霉烯、呋喃妥英、粘菌素和替加环素对产ESBL和AmpC的大肠杆菌和克雷伯氏菌最敏感。
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