DETECTION AND ANTIMICROBIAL SUSCEPTIBILITY PATTERN OF ESBL PRODUCING GRAM NEGATIVE BACTERIA

Abstract

Objective: The ESBL producing organisms has been steadily increasing over the past years. The detection and treatment of these ESBL organisms are extremely limited. In the present study, to determine the Extended Spectrum Beta Lactamases producing organism which were isolated from various samples of Multispeciality hospital in Salem, India. Methods: A total of 278 gram negative isolates were received from various samples were used to detect the ESBL production by using double disk approximation test and Phenotypic confirmatory test with combination disc. The susceptibility of ESBL producers were analysed by antibiotic susceptibility test by using 4 commercially available beta-lactamase inhibitors combinations (Piperacillin/ tazobactam, Ampicillin/Sulbactam, Ticarcillin/Clavulanic acid and Amoxycillin/Clavulanic acid). Results: A total of 351 samples were received, from that 53 Escherichia coli, 73 Klebsiella spp, 37 Pseudomonas aeruginosa, 58 Salmonella spp, 31 Enterobacter spp and 26 Proteus spp were isolated and tested; from the 278 isolates 151 were found to be ESBL producers. From the 151 ESBL producers, P/T exhibited best activity against 134(88.74percent) followed by A/C 128(84.76percent) and A/S 126(83.44percent). T/C 108(71.52percent) shown the poor activity against all the organisms compare to other combination antibiotics. P/T exhibited significantly greater inhibitory activity against Klebsiella spp (96.15percent), E. coli (92.68percent), P. aeruginosa (90.47percent), whereas, A/C exhibited considerable antimicrobial activity against Klebsiella spp (92.30percent) and P. aeruginosa (90.47percent). The A/S exhibited greater inhibitory activity against P. aeruginosa (90.38percent) and Klebsiella spp (90.38percent). P/T, A/C and A/S exhibited better activity against rest of the organisms. All the four agents show good activity against Proteus spp. Conclusion: These data suggest that Amoxycillin/Clavulanic acid and Ampicillin/Sulbactam combination antibiotics showed maximum inhibitory activity against ESBL producers. So, it can be used for the treatment of ESBL infection.