Frequency of extended-spectrum β-lactamase (ESBL)-producing Gram-negative bacilli in a 200-bed multi-specialty hospital in Vellore district, Tamil Nadu, India
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
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 (2006) Influx of extended-spectrum β-lactamase-producing enterobacteriaceae into the hospital. Clin Infect Dis 42: pp. 925-934 CrossRef
- Jacobs, RA, Chin-Hong, PV General problems in infectious diseases. In: McPhee, SJ, Papadakis, MA, Tierney, LM eds. (2007) Current medical diagnosis and treatment. Lange, New York, pp. 1311-1344
- Myer, RM, Koshi, G (2000) Manual of diagnostic procedures in medical microbiology and immunology/serology. Christian Medical College and Hospital, Vellore
- 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 (2003) 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 52: pp. 140-141 CrossRef
- Lalani, T, Varkey, JB, Drew, R (2008) Analysis of two- and three-year trends in antimicrobial resistance in intensive care units using unit-specific antibiograms. Scand J Infect Dis 40: pp. 672-674 CrossRef
- Colodner, R, Rock, W, Chazan, B (2004) Risk factors for the development of extended-spectrum beta-lactamase-producing bacteria in nonhospitalized patients. Eur J Clin Microbiol Infect Dis 23: pp. 163-167 CrossRef
- Peña, C, Gudiol, C, Tubau, F (2006) Risk-factors for acquisition of extended-spectrum β-lactamase-producing Escherichia coli among hospitalised patients. Clin Microbiol Infect 12: pp. 279-284 CrossRef
- Harris, AD, McGregor, JC, Johnson, JA (2007) Risk factors for colonization with extended-spectrum β-lactamase-producing bacteria and intensive care unit admission. Emerg Infect Dis 13: pp. 1144-1149 CrossRef
- Mumtaz, S, Ahmad, M, Aftab, I, Akhtar, N, Hassan, M, Hamid, A (2007) Extended spectrum beta-lactamases in enteric Gram-negative bacilli: related to age and gender. J Ayub Med Coll Abbottabad 19: pp. 107-111
- Kumar, MS, Lakshmi, V, Rajagopalan, R (2006) Occurrence of extended spectrum beta-lactamases among Enterobacteriaceae spp. isolated at a tertiary care institute. Indian J Med Microbiol 24: pp. 208-211
- Khan, AU, Musharraf, A (2004) Plasmid-mediated multiple antibiotic resistance in Proteus mirabilis isolated from patients with urinary tract infection. Med Sci Monit 10: pp. CR598-CR602
- Chatterjee, B, Kulathinal, S, Bhargava, A, Jain, Y, Kataria, R (2009) 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 27: pp. 329-334 CrossRef
- Walsh, TR, Weeks, J, Livermore, DM, Toleman, MA (2011) 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 11: pp. 355-362 CrossRef
- Chaudhuri, BN, Rodrigues, C, Balaji, V (2011) 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 59: pp. 287-292
- Umadevi, S, Kandhakumari, G, Joseph, NM (2011) Prevalence and antimicrobial susceptibility pattern of ESBL producing Gram negative bacilli. J Clin Diagn Res 5: pp. 236-239
- Shriyan, A, Sheetal, R, Nayak, N (2010) Aerobic micro-organisms in post-operative wound infections and their antimicrobial susceptibility patterns. J Clin Diagn Res 4: pp. 3392-3396
- Narayanaswamy, A, Mallika, M (2011) 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 6: pp. 39-43
- Metri, BC, Jyothi, P, Peerapur, BV (2011) The prevalence of ESBL among Enterobacteriaceae in a tertiary care hospital of north Karnataka, India. J Clin Diagn Res 5: pp. 470-475
- Babypadmini, S, Appalaraju, B (2004) 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 22: pp. 172-174
- Abhilash, KPP, Veeraraghavan, B, Abraham, OC (2010) 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 58: pp. 13-17
- Livermore, DM (1995) β-Lactamases in laboratory and clinical resistance. Clin Microbiol Rev 8: pp. 557-584
- Bush, K, Jacoby, GA (2010) Updated functional classification of β-lactamases. Antimicrob Agents Chemother 54: pp. 969-976 CrossRef
- Mathai, E, Chandy, S, Thomas, K (2008) Antimicrobial resistance surveillance among commensal Escherichia coli in rural and urban areas in southern India. Trop Med Int Health 13: pp. 41-45 CrossRef
- Hawkey, PM (2008) Prevalence and clonality of extended-spectrum β-lactamases in Asia. Clin Microbiol Infect 14: pp. 159-165 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
Volume 40, Issue 4 , pp 425-429
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Antibiotic resistance
- Industry Sectors