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Detection of Carbapenem Resistance in Extended Spectrum Beta Lactamase Producing Eshcherichia Coli Isolates in a Tertiary Care Hospital
- Author Details:
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Misbah Najam
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Mallikarjun Koppad
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Halesh L. H.
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Siddesh K. C.
Background: Carbapenems are β-lactam antibiotics, presently considered as the most potent agents for the treatment of multi drug resistant gram negative bacterial infection. Their clinical usage is under threat due to growing incidence of resistance due to production of Carbapenemases which belong to Class B β-lactamases. Knowledge of resistance patterns for Carbapenems will help to guide appropriate and judicious antibiotic use. Hence this study was conducted to detect the resistance to Carbapenems in ESBL producing isolates of E. coli, as the growing incidence of Carbapenem resistance is a major concern to public health.
Objectives: 1. Screening and phenotypic confirmation of ESBL production in E. coli isolates. 2. Screening for Carbapenem resistance in ESBL producing E. coli isolates.
Materials and Methods: Clinical samples consisting of all exudates, sterile body fluids and urine samples were included in our study. Samples were processed and E. coli identified as per routine laboratory protocol. ESBL screening and phenotypic confirmation, followed by screening for Carbapenem resistance was done as recommended by CLSI guidelines 2014.
Results: We isolated 100 ESBL producing E. coli from the samples which were further screened for Carbapenem resistance. Among 100 ESBL producing E. coli isolates, 4(4%) showed Carbapenem resistance, out of which 2 were isloated from urine, 1 each from pus and stool. Co-resistance was observed to other antibiotics including other Cephalosporins(91%), Ampicillin(100%), Piperacillin(95%) and Fluoroquinoles(70%).
Conclusion: Our study highlights an increase in resistance pattern in ESBL producing E. coli isolates towards Carbapenems, which is an alarming situation to microbiologists and clinical physicians of our country. Hence, there is a need to emphasize on rational use of antimicrobials and prevent their misuse which is harmful to both patient and community.
Keywords: Carbapenemase, β-lactam, ESBL, E. coli, Carbapenem resistance