Prevalence of Extended Spectrum Beta Lactamases in Uropathogenic Escherichia coli and Klebsiella Species in a Chennai Suburban Tertiary Care Hospital and its Antibiogram Pattern

The prevalence of Extended Spectrum Beta Lactamases (ESBL) among uropathogenic bacteria have increased over time raising a global concern in the therapeutic management of infections caused by these organisms. ESBLs contribute to multidrug resistance among the organisms and detection of these enzymes is crucial in analyzing the antibiogram pattern of such isolates for empirical therapy. The aim of the study was to analyze the prevalence of ESBL producers among UTI patients of a tertiary care hospital in Chennai suburban. Among 131 clinical isolates obtained from patients, E. coli and Klebsiella species were identified to be the dominant uropathogens. Production of Extended Spectrum Beta Lactamases (ESBL) was detected among E. coli and Klesiella species following the methods recommended by the CLSI including the double disc diffusion test and phenotypic confirmatory test. About 47% of E. coli and 36% of Klebsiella species were identified as ESBL producers. Co-resistance to non-β-lactam antibiotics such as gentamycin, co-trimoxazole, nitrofurantoin and ciprofloxacin was demonstrated by Kirby-Bauer method. ESBL producing isolates of E. coli and Klebsiella species were found to be resistant to more than three antibiotics. Imipenem was found to be the most effective drug against most of the isolates tested followed by amikacin. It is concluded that there is an urgent need for the microbiology laboratories in the suburban of Chennai to include ESBL detection procedures as a routine along with conventional antibiogram analysis for obtaining better therapeutic options.