Online ISSN: 2515-8260

Keywords : ESBL

Study of antibiotic sensitivity pattern of extended spectrum β-lactamase (ESBL) producing organisms in pediatric patients at a tertiary care hospital

Parag Mahankar, Bibhudatta Dash, Dr. Priyanka Badjate

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 1038-1046

Background: The broad spectrum ß-lactam antibiotics are commonly used empirically for the treatment of gram negative sepsis. But the emergence of ESBL producing organisms has posed a serious threat for their continuing use. Present study was undertaken to find out the magnitude of the problem of infections due to extended spectrum β-lactamase producing organisms.
Material and Methods: Present study was a descriptive & observational study, conducted in patients < 18 years age, all cultures showing a significant growth of ESBL producing organisms from any of the clinical specimens, as per CLSI guidelines.
Results: Infections by ESBL producing organisms were found more common in 13-18 years of age group (36.25%) & males (71.25%). K. pneumoniae has been found to be the most commonly isolated ESBL producing organism (56.25%) followed by E. coli (38.75%). ESBL producing organisms were most commonly grown in urine samples (51.25%) followed by pus culture (11.25%) and blood (10%). All were sensitive to tigecycline and colistin (100%). In the carbapenem group, sensitivity to imipenem was highest (93.75%) followed by ertapenem (66.25%), doripenem (65%) and meropenem (53.75%). Among the 45 isolates of ESBL K. pneumoniae, all were sensitive to tigecycline and colistin. Sensitivity to imipenem is 93.33% while that to meropenem, doripenem and ertapenem were 46.66%, 62.22% and 64.44% respectively. Out of the 31 isolates of ESBL producing E. coli, all were sensitive to tigecycline and colistin. Sensitivity to Imipenem was 96.77% while that to meropenem, doripenem and ertapenem were 64.71%, 70.96% and 70.96% respectively. Sensitivity to meropenem has gone down dramatically from 71.42% to 22.22%, which is significant.
Conclusion: A growing resistance in the ESBL producing organisms is noted which is very alarming. A limited number of drugs are available against these ESBL producing organisms and the drug of choice is carbapenem.

Bacteriological profile of orthopaedic implant site infection and their antimicrobial susceptibility pattern in a tertiary care hospital

Santosh Kumar, Dharitri Mohapatra, Sasmita Khatua, Nirupama Chayani

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 1207-1217

Orthopaedic implant site infection is one of the major surgical site infection in orthopaedic surgery with high morbidity and mortality. Due to the use of implants, which are foreign to the body, orthopaedic trauma surgery is at the grave risk of microbial contamination. Overall 5% of the internal fixation devises get infected. The incidence of infection after internal fixation of closed fractures is generally lower (0.5-1%), where as in case of internal fixation of open fractures, the incidence is still higher and may exceed 30%. The prevalence of orthopaedic implant site infection reported in India is about 2.6%.

Molecular Characterization of Extended Spectrum Beta-Lactamase Producing Bacteria Isolated from a River Surface Water

Fazlul MKK; Mohamad Farouk Abdullah; Nomani Kabir; Saeid Reza Doustjalali; Negar Shafiei Sabet; Srikumar C; Rashid MA; Jassim M. SaadounMohammed A. KadhimSalah M. S. Al-Atab; Nazmul MHM

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 1, Pages 1570-1580

The existence and prevalence of multi-drug resistant extended-spectrum βlactamase (ESBL)-producing bacteria in the river water is a major cause of numerous diseases worldwide. In this study, the molecular characterization of antimicrobial-resistant bacteria producing ESBL encoding genes was investigated for a better understanding of the risk factors and public health issues. The potential ESBL-producing bacterial species were detected using 16S ribose ribonucleic acid (rRNA) polymerase chain reaction (PCR). This served as a screening step to detect potential ESBLs encoding genes which were confirmed by phenotypes (DDST and E-test) and genotypes (PCR) assays with the presence of the bla genes; TEM, CTX-M, OXA-1 and SHV. Furthermore, all the confirmed bacterial isolates producing ESBL encoding genes were analysed for antibiotic susceptibility patterns against 10 different classes of antibiotics as a choice of therapy using antibiotic susceptibility testing (AST) by the disc diffusion method. The highest bacterial isolates were confirmed as Enterobacteriaceae (89.5%), predominantly Escherichia coli and Klebsiella pneumoniae. Among the 20 bacterial isolates, 12 (60 %) bacteria possessed one or more ESBLs encoding genes. Relatively high occurrence rates of β-lactamase genes; bla TEM 35%, bla SHV 20%, bla OXA-15% and bla CTX-M 10% were recorded. All the ESBLs encoding isolates showed high resistance to penicillin’s, third-generation cephalosporins, monobactams, cephamycins and carbapenems. High occurrences of ESBLs producing bacteria in the environment pose a threat to exposed communities. Therefore, early detection of MDR beta-lactamase mediated resistance genes are essential to avoid numerous diseases due to the dissemination of ESBLs producing strains.