Risk factors for acquisition of extended spectrum beta lactamase producing Escherichia coli and Klebsiella pneumoniae in North-Indian hospitals

Abstract

Multidrug resistance and production of extended spectrum β-lactamases (ESBLs) by enteric gram negative rods in hospitals and community continue to be a matter of scientific concern. This retrospective study was executed to assess the prevalence of ESBL-producing Escherichia coli and Klebsiella pneumoniae at two North Indian hospitals and to determine the risk factors associated with the acquisition of these organisms. A total of 346 bacterial isolates were obtained. Of these, 48.27% (n = 167) were confirmed to be ESBL producers while 51.73% (n = 179) were non ESBL-producers. Among the ESBL producers, 55.69% (n = 93) were E. coli and 44.31% (n = 74) were K. pneumoniae. ESBL producing isolates showed co-resistance to multitude of antibiotics tested. Length of hospital stay (>3 days) and previous exposure to antibiotics were found as significant risk factors (p = 0.01 and 0.02) associated with the acquisition of ESBL-producing E. coli and K. pneumoniae isolates. Imipenem and meropenem can be suggested as drugs of choice in our study.

Extended-Spectrum Beta-Lactamase Producing Escherichia coli and Klebsiella pneumoniae are Emerging as Major Pathogens Responsible for Urinary Tract Infection

“…In one report from Nepal, ESBL positivity for E. coli and K. pneumoniae from urine samples were 13.41% and 16.55% respectively 17 . One North Indian report showed these figures as 5% and 13% respectively 10 .…”

“…Extended-spectrum beta-lactamase (ESBL) producing E. coli and K. pneumoniae are increasingly being isolated in cultures from urine samples in Bangladesh 5-8 . Advanced age, diabetes mellitus (DM), use of urinary catheters, previous hospital admission and antibiotic intake are reported as risk factors for ESBL positivity 9,10 . Data regarding ESBL positive organisms are limited in our country.…”

Frequency, Risk Factors and Antibiotic Sensitivity Pattern of Extended-Spectrum Beta-Lactamase Producing Escherichia coli and Klebsiella pneumoniae Causing Urinary Tract Infection: Experience from a Tertiary Care Hospital of Bangladesh

“…10,[16][17][18][19] Antibiotic sensitivity patterns were also similar. [6][7][8][9][10][16][17][18] Current study had some limitations. It was a single center study, comprising small number of study population over a short period of time and most of our study participants were diabetic.…”

“…[5][6][7][8][9] Diabetes mellitus (DM), past history of UTI and prior antibiotic use are reported risk factors for UTI due to ESBL-positive organisms. 10,11 In this study, we have tried to evaluate the frequency of UTI due to ESBL-positive Escherichia coli and Klebsiella pneumoniae, their antibiotic sensitivity patterns and risk factors.…”

Toxicity of β-Lactam Antibiotics: Pathophysiology, Molecular Biology and Possible Recovery Strategies

“…Likewise, patients with medical devices like urinary catheters are also prone to antibiotic-resistant bacteria [38]. Moreover, the length of hospital stay is another risk factor; patients who have stayed more than 3 days in hospitals and who have been previously treated with β-lactam antibiotics might be considered as a risk factor for the acquisition of β-lactamase resistance [39]. Furthermore, it has been reported in Italy that the risk factors for ESBL-producing S. marcescens and K. pneumoniae acquisition in neonatal ICU include low birthweight, gestational period and the use of invasive devices [40].…”