Extended Spectrum β Lactamase Producing Lactose Fermenters Causing Neonatal Septicaemia in a Tertiary Care Center in Uttar Pradesh

Abstract

Introduction: Extended-spectrum Beta-lactamase (ESBL) producing enterobacteriaceae are of escalating concern in today's antibiotic era especially in neonatal sepsis. This study was conducted to determine the prevalence of ESBL producing E.coli and Klebsiella species in neonatal sepsis. Material and Methods: This cross sectional study included 382 samples with signs and symptoms of neonatal sepsis. Blood cultures were done and the isolates were identified using standard biochemical tests and antibiotic susceptibility testing was performed by Kirby Bauer method. Betalactamase productions of the isolates were tested by combined disc diffusion test. Results: Out of 382 samples, 124 (32.46%) samples [males were n=78/227 (34.36%) and 46/155 (29.67%) in females] were culture positive. The culture positivity among the Early Onset Neonatal Sepsis and Late Onset Neonatal Sepsis cases were 47.38% (n=59/124) and 52.42% (n=65/124).; The most common risk associated factors were premature birth, low birth weight, caesarian section etc among EONS and Low birth weight, premature birth, invasive procedures etc among LONS. Among the etiological agents, Staphylococcus aureus (n=24/47) (51.06%) and Coagulase negative Staphylococci (CoNS) (n=14/47) (29.79%) were most frequently isolated among Gram positive and Escherichia coli (n=30/73) (41.09%) followed by Klebsiella species (n=23/73) (31.51%) among the Gram negative isolates. ESBL production was seen in n=24/53 (45.28%) isolates [Escherichia coli n=13 (54.17%) and Klebsiella species n=11 (45.83%)]. Colistin and Imipenem are the most sensitive antibiotics for Escherichia coli and Klebsiella species. Conclusion: High prevalence of ESBL producing E.coli and Klebsiella species was recorded among neonatal septicaemic cases. Testing of ESBL should be regularly done to formulate the empirical therapy based on region.

Prevalence of Extended Spectrum Beta Lactamase and molecular detection of blaTEM, blaSHV and blaCTX-M genotypes among Gram Negative Bacilli Isolates from Pediatric Patient Population in Gaza strip

“…Using phenotypic the prevalence of ESBL producing Gram-negative bacilli isolates was 51.6% (166/322). Our results were comparable with those of Mishra et al [41]. Another study showed that 48.3% of their cefotaxime resistant Gram-negative bacilli were ESBL producers [42].…”

Prevalence of ESBL in Isolates of Klebsiella pneumoniae and E. coli in Suspected Cases of Neonatal Septicemia in Tertiary Care Hospital in North Maharashtra, India

“…of ESBL production was seen among Klebsiella pneumoniae (54.17%) and E. coli (44.44%). This was similar to results of Khanna et al, 2016, Prem Mishra et al, 2018and Gandhi et al, 2013 In the present study, 89 -100% resistance against 3 rd generation cephalosporins was observed among ESBL producing strains of Klebsiella pneumoniae and E. coli. Similar results reported by Islam et al, 2014 which reported all ESBL positive strains of E. coli were resistant to Cefotaxime, Ceftriaxone and Ceftazidime as compared to non ESBL isolates (30 -71%).…”

“…Bacteriological profile of Neonatal Septicemia Distribution of culture positive cases among EONS & LONS cases ESBL production in Gram negative bacterial isolates Klebsiella pneumoniae and E. coli. This was in line with results of PremMishra et al, 2018. …”