PHENOTYPIC IDENTIFICATION OF EXTENDED SPECTRUM BETA LACTAMASE AND METALLO BETA LACTAMASE PRODUCTION AMONG ISOLATES OF ENTEROBACTERIACEAE IN A TERTIARY CARE HOSPITAL, UDAIPUR, RAJASTHAN

Antimicrobial resistance is a growing threat worldwide. Increasing resistance to third generation cephalosporins has become a cause for more concern among Enterobacteriaceae. The prevalence of extended spectrum -lactamases (ESBLs) and metallobetalactamases (MBL) among members of Enterobacteriaceae constitutes a serious threat to current situation of -lactam therapy leading to treatment failure. 100 Enterobacteriaceae isolated from various clinical samples were included in the study. ESBL was detected by phenotypic conrmatory disc diffusion test (PCDDT) using ceftazidime alone and in combination with clavulanic acid. MBLdetection was done by Imipenem EDTA combined disc diffusion test. Out of 100 Enterobacteriaceae isolates, 47(47%) were ESBL producers and 29 (29%) were MBLproducers. None of the isolates showed the coexistence of ESBLand MBLin the same isolate. ESBLand MBLproduction was observed in E.coli, Klebsiella spp., Acinetobacter spp. and Citrobacter spp. isolated from various clinical samples. The study underlines problem of ESBL and MBL mediated resistance, which has created a therapeutic challenge for the clinicians and microbiologists. Simple disk method can be routinely employed to detect these common resistance mechanisms which will reduce the mortality and also spread of such resistant strains.

[1]  Kanwardeep Singh,et al.  Prevalence and Antimicrobial Resistance Pattern of Extended Spectrum Beta Lactamase Producing Gram Negative Bacterial Isolates Obtained From Various Clinical Samples of Indoor Patients Admitted in a Tertiary Care Hospital , 2019, International Journal of Contemporary Medical Research [IJCMR].

[2]  D. Bhandari,et al.  A hospital based surveillance of metallo-beta-lactamase producing gram negative bacteria in Nepal by imipenem-EDTA disk method , 2017, BMC Research Notes.

[3]  M. Salam,et al.  Detection of extended spectrum β-lactamase in Pseudomonas spp. isolated from two tertiary care hospitals in Bangladesh , 2013, BMC Research Notes.

[4]  Varun Goel,et al.  Prevalence of extended-spectrum beta-lactamases, AmpC beta-lactamase, and metallo-beta-lactamase producing Pseudomonas aeruginosa and Acinetobacter baumannii in an intensive care unit in a tertiary care hospital , 2013 .

[5]  Judith A. Johnson,et al.  Extended-spectrum beta-lactamase-producing Gram-negative bacteria causing neonatal sepsis in India in rural and urban settings. , 2011, Journal of medical microbiology.

[6]  S. Srirangaraj,et al.  Microbiological study of diabetic foot infections , 2011 .

[7]  B. V. Krishna,et al.  New Delhi metallo-beta-lactamases: a wake-up call for microbiologists. , 2010, Indian journal of medical microbiology.

[8]  S. Basu,et al.  A Study on Infections Caused By Metallo Beta Lactamase Producing Gram Negative Bacteria in Intensive Care Unit Patients , 2010 .

[9]  S. Upadhyay,et al.  Presence of different beta-lactamase classes among clinical isolates of Pseudomonas aeruginosa expressing AmpC beta-lactamase enzyme. , 2010, Journal of infection in developing countries.

[10]  F. Baquero,et al.  Increasing prevalence of ESBL-producing Enterobacteriaceae in Europe. , 2008, Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin.

[11]  P. N. Sridhar Rao,et al.  Detection of extended spectrum beta-lactamase from clinical isolates in Davangere. , 2008, Indian journal of pathology & microbiology.

[12]  D. Plachouras,et al.  Evaluation of different laboratory tests for the detection of metallo-beta-lactamase production in Enterobacteriaceae. , 2008, The Journal of antimicrobial chemotherapy.

[13]  Harald Seifert,et al.  Detection of Extended-Spectrum Beta-Lactamases among Enterobacteriaceae by Use of Semiautomated Microbiology Systems and Manual Detection Procedures , 2007, Journal of Clinical Microbiology.

[14]  V. Lakshmi,et al.  Occurrence of extended spectrum beta-lactamases among Enterobacteriaceae spp. isolated at a tertiary care institute. , 2006, Indian journal of medical microbiology.

[15]  M. Toyokawa,et al.  Metallo-β-Lactamase-Producing Gram-Negative Bacilli: Laboratory-Based Surveillance in Cooperation with 13 Clinical Laboratories in the Kinki Region of Japan , 2004, Journal of Clinical Microbiology.

[16]  Amita Jain,et al.  Prevalence of extended-spectrum beta-lactamase-producing Gram-negative bacteria in septicaemic neonates in a tertiary care hospital. , 2003, Journal of medical microbiology.

[17]  P. Fey,et al.  Extended Spectrum β-Lactamase (ESBL)-Producing Enterobacteriaceae , 2012, Drugs.