Objectives: Detection of extended-spectrum β-lactamases (ESBLs) is crucial for the infection control and antibiotic choice in healthcare settings. The aim of this study is to develop a standardized, inexpensive, and simple approach that is able to detect ESBL-producing Enterobacteriaceae isolates. Methods:Isolates those were resistant to at least one of the three indicator cephalosporins (cefotaxime, cefpodoxime, and ceftazidime) were tested for ESBL production using the double disc synergy test (DDST), combined disc synergy test (CDST) test and genotypic detection of the responsible gene for the ESBL.Result: From 64 isolates, 28 were resistant to cephalosporins. In 28 isolates, 23 were positive in CDST but in the DDST 18 were showing ESBL positive. 10 were positive in both CDST and DDST. Conclusion:Resistance to cephalosporins, which are the drug choice to treat mixed bacterial infections by the Enterobacteriaceae of which disseminate rapidly being plasmid mediated. Hence, it is necessary that rapid detection of ESBL should be done and immediate infection control measures should be implemented to prevent their dissemination.
Objective: Beta-lactams are the group of antibiotics that contain a ring called as "beta-lactam ring," which is responsible for the antibacterial activity. The presence of resistance among Gram-negative organisms is due to the production of beta-lactamases enzymes that hydrolysis the beta-lactam ring thereby conferring resistance to the organism. This study is undertaken to determine the prevalence of extended-spectrum beta-lactamase (ESBL) producing Gram-negative organism from clinical samples. Methods:A total of 112 clinical samples were taken for this study. The combined disc synergistic test (CDST) was used for the phenotypic detection of ESBL producers from the clinical samples. The genotypic identification of ESBL producers was carried out by alkaline lysis method by isolation of plasmid DNA.Result: A total of 87 bacterial isolates were isolated and identified. Among them, Klebsiella (41%) was the predominant organism followed by Escherichia coli (33%), Proteus (10%), Pseudomonas (10%), and Serratia (6%). Among the various bacterial isolates, Klebsiella showed a higher percentage of resistance. The CDST showed that 8 isolates of Klebsiella, 3 isolates of E. coli, and 1 isolate of Pseudomonas were found to be ESBL producers. The genotypic confirmation showed that the two bacterial isolates, namely, Klebsiella and E. coli were found to possess temoniera (TEM) gene which was the 400-500 bp conferring resistance to the antibiotics. Conclusion:The results of this study suggest that early detection of ESBL producing Gram-negative organism is a very important step in planning the therapy of patient in Hospitals. CDST continues to be a good indicator in the detection of ESBL producers.
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