Detection of extended spectrum beta-lactamase producing organisms and its antibiotic resistance pattern among Enterobacteriaceae isolates in a teaching hospital of Eastern India

Abstract

Introduction: ESBL-producing Enterobacteriaceae have been responsible for innumerable outbreaks of infection throughout the world and are becoming a real challenge to control the spread of infection. Aim To determine the prevalence of ESBL producing organisms among Enterobacteriaceae isolated from different clinical samples and to detect their antibiotic susceptibility patterns. Material and Methods The study was conducted in the Department of Microbiology, College of Medicine and JNM hospital. A total of 241 samples showing pure growth of Enterobacteriaceae were included in the study. Identification followed by antibiotic susceptibility tests were performed according to CLSI guidelines. Organisms showing reduced susceptibility to third generation cephalosporins were further tested by double disc synergy test to detect ESBL production and those ESBL screening positive isolates were further tested by Phenotypic confirmatory test according to CLSI 2019 guidelines. Results: Prevalence of ESBL producing Enterobacteriaceae was found to be 31.04% with the highest rate among E.coli (34.5%) followed by K. pneumoniae (27.6%). and P. mirabilis (24.2%) .All the ESBL isolates were sensitive to meropenem and imipenem. Nitrofurantoin (84.2%) was found to be most effective drug for ESBL isolates from urine samples. Among β-Lactam/ β-Lactam inhibitor drugs, amoxicillin/clavulanic acid was found to be less sensitive compared to cefoperazone/sulbactam (67%) . Most of the ESBL isolates were found to be multidrug resistant. Conclusion: Screening of all the gram-negative organisms for ESBL detection and judicial use of antibiotics as per sensitivity report is utmost important to prevent the spread of resistance strains in the community as well as in hospital. Formulation of infection control committee in every hospital may help to combat the present situation.