Prevalence and antibiogram of Extended Spectrum β-Lactamase (ESBL) producing Gram negative bacilli and further molecular characterization of ESBL producing Escherichia coli and Klebsiella spp.

Abstract

Background and Objectives: Resistance to a wide variety of common antimicrobials has made the proliferation of Extended spectrum β-lactmase (ESBL) producing strains a serious global health concern that has complicated treatment strategies. The high proportion of ESBL producers among the Enterobacteriaceae and the complex molecular epidemiology with diverse types of ESBL genes are alarming. This study was undertaken to identify ESBL production in various Gram negative bacilli isolated and to further characterize ESBL producers among Escherichia coli and Klebsiella spp by PCR, which were initially screened by phenotypic method. Materials and Methods:A total of 722 isolates of Gram negative bacilli were isolated. Presence of ESBL positivity was detected using the double disk synergy test (DDST). Their antibiogram was studied. PCR analysis for β-lactamase (bla) genes of the family TEM, SHV and CTX-M was also carried out using designed primers in 20 ESBL isolates each of Escherichia coli and Klebsiella spp.Results: Among 722 Gram negative bacilli isolated 379 (52.49%) were ESBL producers. The major source of ESBL producers were respiratory tract samples, highest ESBL production was observed in Klebsiella sp. (67.04%). Resistance to multiple classes of antibiotics was observed among ESBL producers. Among ESBL producing genes prevalence of bla-CTX-M (82.5%) was highest, followed by bla-TEM (67.5%) and bla-SHV (57.5%) in the present study. The frequency of ESBL producing strains among clinical isolates has been steadily increasing. Advance drug resistance surveillance and molecular characteristics of ESBL isolates is necessary to guide the appropriate and judicious antibiotic use.

Prevalence and antibiogram of ESBL producing gram negative bacilli isolated from urine in Dhaka Medical College Hospital, Bangladesh

“…A high prevalence of ESBL producers reduces therapeutic options and creates a need to report them routinely in laboratories because ESBL producers are significantly resistant to both ß-lactams and non ß-lactams than non-ESBL producers. In present study, regarding antimicrobial susceptibility imipenem was the most effective antibiotic against ESBL producers which correlates with the other studies 6,26 .…”

Biofilm formation and antimicrobial resistance in Klebsiella pneumoniae isolated from patients visiting a tertiary care center of Nepal

“…Our result was lower than that found in India which showed 67.04% of ESBL producing Klebsiella spp. [30]. Epidemiological studies have highlighted that the increasingly widespread use of third-generation cephalosporins is a major risk factor contributing to the emergence of ESBL producing K. pneumoniae [31][32][33].…”

Częstość zakażeń i kolonizacji Klebsiella pneumoniae izolowanych od chorych leczonych na oddziale anestezjologii i intensywnej terapii

“…Dodatkowy problem stanowi wspomniana już różnorodność tych enzymów oraz łatwy sposób ich przekazywania nie tylko w obrębie szczepów jednego gatunku, ale także rodziny czy grup bakterii. Znanych jest ponad 300 wariantów beta-laktamaz ESBL [13]. Najczęściej izolowane są szczepy gatunków z rodziny Enterobacteriaceae wytwarzające beta-laktamazy typu ESBL z rodzin: CTX-M, TEM i SHV [14].…”