Frequency of extended-spectrum β-lactamase (ESBL)-producing Gram-negative bacilli in a 200-bed multi-specialty hospital in Vellore district, Tamil Nadu, India
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Extended-spectrum β-lactamase (ESBL) producers were reported only from hospital settings previously, but, nowadays, its common presence in community settings is evident from reports. Our primary aim was to assess the frequency of ESBL-producing Gram-negative bacteria (GNB) and their antibiogram pattern among the clinical isolates received during an 8-month time period.
The clinical isolates which belonged to the family Enterobacteriaceae from the clinical specimens were included in the study. These clinical isolates were tested for ESBL production using the double-disk synergy test.
In total, 301 patients were included in this study, of which 146 (48.50 %) were found to harbor strains of ESBL producers. The acquisition of ESBL in relation to age, sex, inhabitancy, inpatients, and outpatients was also analyzed. In our study, 50.29 % of inpatients and 45.86 % of outpatients were found to harbor ESBL producers. The difference between the two groups was not statistically significant. We found five meropenem-resistant ESBL-producing strains among the 146 ESBL producers. Rural inhabitants were found to contain more ESBLs when compared to peri-urban inhabitants.
The study showed a high frequency of ESBLs in both community-acquired and hospital-acquired infections. The frequency of ESBLs was higher among isolates from patients who were from rural populations than those from peri-urban populations. The data on ESBL frequency suggests the need for a rational antibiotic use which would reduce the spread of ESBL-producing members of the family Enterobacteriaceae.
- Ben-Ami R, Schwaber MJ, Navon-Venezia S, et al. Influx of extended-spectrum β-lactamase-producing enterobacteriaceae into the hospital. Clin Infect Dis. 2006;42:925–34. CrossRef
- Jacobs RA, Chin-Hong PV. General problems in infectious diseases. In: McPhee SJ, Papadakis MA, Tierney LM, editors. Current medical diagnosis and treatment. 46th ed. New York: Lange; 2007. p. 1311–44.
- Myer RM, Koshi G. Manual of diagnostic procedures in medical microbiology and immunology/serology. Vellore: Christian Medical College and Hospital; 2000. p. 137–62.
- Clinical Laboratory Standards Institute (CLSI). Performance standards for antimicrobial susceptibility testing; Twentieth informational supplement. CLSI document M100-S20. Wayne: CLSI; 2010.
- Andrade SS, Jones RN, Gales AC, Sader HS. Increasing prevalence of antimicrobial resistance among Pseudomonas aeruginosa isolates in Latin American medical centres: 5 year report of the SENTRY Antimicrobial Surveillance Program (1997–2001). J Antimicrob Chemother. 2003;52:140–1. CrossRef
- Lalani T, Varkey JB, Drew R, et al. Analysis of two- and three-year trends in antimicrobial resistance in intensive care units using unit-specific antibiograms. Scand J Infect Dis. 2008;40:672–4. CrossRef
- Colodner R, Rock W, Chazan B, et al. Risk factors for the development of extended-spectrum beta-lactamase-producing bacteria in nonhospitalized patients. Eur J Clin Microbiol Infect Dis. 2004;23:163–7. CrossRef
- Peña C, Gudiol C, Tubau F, et al. Risk-factors for acquisition of extended-spectrum β-lactamase-producing Escherichia coli among hospitalised patients. Clin Microbiol Infect. 2006;12:279–84. CrossRef
- Harris AD, McGregor JC, Johnson JA, et al. Risk factors for colonization with extended-spectrum β-lactamase-producing bacteria and intensive care unit admission. Emerg Infect Dis. 2007;13:1144–9. CrossRef
- Mumtaz S, Ahmad M, Aftab I, Akhtar N, ul Hassan M, Hamid A.. Extended spectrum beta-lactamases in enteric Gram-negative bacilli: related to age and gender. J Ayub Med Coll Abbottabad. 2007;19:107–11.
- Kumar MS, Lakshmi V, Rajagopalan R. Occurrence of extended spectrum beta-lactamases among Enterobacteriaceae spp. isolated at a tertiary care institute. Indian J Med Microbiol. 2006;24:208–11.
- Khan AU, Musharraf A. Plasmid-mediated multiple antibiotic resistance in Proteus mirabilis isolated from patients with urinary tract infection. Med Sci Monit. 2004;10:CR598–602.
- Chatterjee B, Kulathinal S, Bhargava A, Jain Y, Kataria R. Anti-microbial resistance stratified by risk factor among Escherichia coli strains isolated from the urinary tract at a rural clinic in central India. Indian J Med Microbiol. 2009;27:329–34. CrossRef
- Walsh TR, Weeks J, Livermore DM, Toleman MA. Dissemination of NDM-1 positive bacteria in the New Delhi environment and its implications for human health: an environmental point prevalence study. Lancet Infect Dis. 2011 May;11:355–62. CrossRef
- Chaudhuri BN, Rodrigues C, Balaji V, et al. Incidence of ESBL producers amongst Gram-negative bacilli isolated from intra-abdominal infections across India (based on SMART study, 2007 data). J Assoc Physicians India. 2011;59:287–92.
- Umadevi S, Kandhakumari G, Joseph NM, et al. Prevalence and antimicrobial susceptibility pattern of ESBL producing Gram negative bacilli. J Clin Diagn Res. 2011;5:236–9.
- Shriyan A, Sheetal R, Nayak N. Aerobic micro-organisms in post-operative wound infections and their antimicrobial susceptibility patterns. J Clin Diagn Res. 2010;4:3392–6.
- Narayanaswamy A, Mallika M. Prevalence and susceptibility of extended spectrum beta-lactamases in urinary isolates of Escherichia coli in a tertiary care hospital Chennai—South India. Internet J Med Update. 2011;6:39–43.
- Metri BC, Jyothi P, Peerapur BV. The prevalence of ESBL among Enterobacteriaceae in a tertiary care hospital of north Karnataka, India. J Clin Diagn Res. 2011;5:470–5.
- Babypadmini S, Appalaraju B. Extended spectrum β-lactamases in urinary isolates of Escherichia coli and Klebsiella pneumoniae—prevalence and susceptibility pattern in a tertiary care hospital. Indian J Med Microbiol. 2004;22:172–4.
- Abhilash KPP, Veeraraghavan B, Abraham OC. Epidemiology and outcome of bacteremia caused by extended spectrum beta-lactamase (ESBL)-producing Escherichia coli and Klebsiella spp. in a tertiary care teaching hospital in south India. J Assoc Physicians India. 2010;58:13–7.
- Livermore DM. β-Lactamases in laboratory and clinical resistance. Clin Microbiol Rev. 1995;8:557–84.
- Bush K, Jacoby GA. Updated functional classification of β-lactamases. Antimicrob Agents Chemother. 2010;54:969–76. CrossRef
- Mathai E, Chandy S, Thomas K, et al. Antimicrobial resistance surveillance among commensal Escherichia coli in rural and urban areas in southern India. Trop Med Int Health. 2008;13:41–5. CrossRef
- Hawkey PM. Prevalence and clonality of extended-spectrum β-lactamases in Asia. Clin Microbiol Infect. 2008;14:159–65. CrossRef
- Ganguly NK; Global Antibiotic Resistance Partnership—India National Working Group. Situation analysis. Antibiotic use and resistance in India. 2011. http://www.cddep.org/publications/situation_analysis_antibiotic_use_and_resistance_india. Accessed 12 Jul 2011.
- Frequency of extended-spectrum β-lactamase (ESBL)-producing Gram-negative bacilli in a 200-bed multi-specialty hospital in Vellore district, Tamil Nadu, India
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