Prevalence of ESBL in Escherichia coli Isolates Among ICU Patients in a Tertiary Care Hospital
Introduction: Resistance to common antibiotics is a matter of grave concern in treating infections in hospital settings especially in Intensive Care Units (ICUs). One of the most commonly used and effective group of antibiotics, cephalosporins, exhibit resistance due to production of Extended Sp...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2016-09-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/8544/21260_CE(RA1)_F(T)_PF1(AHESAK)_PFA(AK).pdf |
| Summary: | Introduction: Resistance to common antibiotics is a matter of
grave concern in treating infections in hospital settings especially
in Intensive Care Units (ICUs). One of the most commonly used
and effective group of antibiotics, cephalosporins, exhibit
resistance due to production of Extended Spectrum BetaLactamases (ESBLs). The prevalence of ESBL producing
Escherichia coli (E.coli) has increased throughout the world
and is a major cause of treatment failure in ICUs. As per our
knowledge studies were not available on the prevalence of
ESBL producing E.coli in ICUs of this region.
Aim: To determine the prevalence of ESBLs among Escherichia
coli isolates in ICUs of a tertiary care hospital.
Materials and Methods: A cross sectional study was
conducted over a period of 4 years (Sept 2011 to Sept 2015)
in the Department of Microbiology, Kalinga Institute of Medical
Sciences (KIMS), Bhubaneswar. Consecutive non-duplicate
isolates of E.coli recovered from 6800 clinical samples of
patients admitted to different Intensive Care Units (ICUs) were
subjected to ESBL screening test and then to CLSI recommended Phenotypic Confirmatory Disc Diffusion Tests (PCDDT)
for ESBL production determination.
Results: Out of 6800 samples, 1038 were E.coli isolates and
452(44%) were resistant to third generation cephalosporins.
ESBL producing Escherichia coli among them were 276 (61.1%).
Paediatric ICU showed the highest prevalence of ESBL E.coli
at 80.9%. The highest prevalence of ESBL E.coli was in urine
samples (82.6%) followed by pus (9.8%). The most effective
antibiotic for ESBL producers was imipenem (96.7% sensitive),
followed by amikacin (88.4%) and piperacillin- tazobactum
(87%).
Conclusion: This study has highlighted the high prevalence
of ESBL producing E.coli in the ICUs of our hospital. An in
depth analysis of their antibiogram will be helpful in formulating
the antibiotic policy and prevent spread of ESBL strains. It
is recommended that ESBL testing should be done routinely
to curtail antibiotic resistance and to effectively implement
infection control measures. |
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| ISSN: | 2249-782X 0973-709X |