Prevalence of ESBL And AmpC ?-Lactamase in Gram Negative Bacilli in various Clinical Samples at Tertiary Care Hospital

摘要

The rapid dispersal of antibiotic resistance as extended spectrum beta lactamases (ESBLs) and AmpC β-lactamases in bacteria makes a major public health concern worldwide. It becomes essential to guide the clinicians about the Knowledge of their occurrence and the appropriate anti-microbial treatment. This study was done to evaluate the Prevalence of ESBL and AmpC β-lactamases and their antibiotic susceptibility in gram-negative clinical isolates were analyzed. Total 200 non repetitive clinical isolates of {Escherichia coli (n=101), Klebsiella spp (n=41), Citrobacter spp. (n=22), Pseudomonas spp. (n=20), Proteus spp.(n=5), Acinetobacter spp.(n=7) and Enterobacter spp.( n=4)} obtained over a period from (January to August, 2014), were screened by Kirby Bauer disc diffusion method for ESBLs and AmpC production and suspected isolates were confirmed by combined disc and AmpC disc tests. From 117(58.5%) and 62 (31%) screened out isolates, 87(43.5%) and 44(22%) were found to be ESBL and AmpC producers respectively. The distribution of ESBL and AmpC isolates organism wise showed E.coli (44.5% and 21.9%), Klebsiella spp (41.4% and 24.3%), Pseudomonas spp. (30% and 20%) and Acinetobacter spp (28.6 and 14.3%) respectively and they were found significantly multidrug resistance too. The co-existence phenotype of both ESBLs and AmpC were 23(11.5%) isolates. In our hospital moderate prevalence of ESBLs and AmpC was found. Combination disc test was effective for ESBL detection While the AmpC disc test, was found to be a convenient, specific and highly sensitive. Regular monitoring is necessary for the incidence of the ESBL and AmpC β-lactamase production by organisms.