Prevalence of ESBL-mediated Resistance among Hospital and Community isolates of Klebsiella pneumoniae in Warangal
Abstract
Introduction: Extended Spectrum β-Lactamase (ESBL) producing Klebsiella pneumoniae were prevalent in the hospital environment and were responsible for many hospital associated infections (HAIs).The present study was aimed at identifying these strains in the hospital environment so as to guide the clinician in planning antibiotic policy.
Material and Methods: 200 clinical isolates of Klebsiella pneumoniae constituted the study group.100 isolates were from the community and 100 from the hospital. Based on their susceptibility or resistance to 3rd generation cephalosporins (3GCs), the isolates were characterized into two groups. Group I consisted of sensitive strains(128 numbers) which showed a zone diameter of more than 17mm and group II consisted of resistant strains(72 numbers) which showed a zone diameter of less than 17mm to ceftazidime (30µg), cefotaxime (30µg) and ceftriaxone (30µg). Isolates of group II were tested for ESBL production using two methods namely double disc synergy test (DDST) and phenotypic confirmatory disc diffusion test (PCDDT).
Results: Among the 72 resistant strains, 36 (50%) were ESBL producers and 36 (50%) were non-ESBL producers. Among the hospital isolates, the percentage of ESBL producers was more (30%) compared to the community isolates (6%).
Conclusion: About one third of the hospital isolates of Klebsiella pneumoniae showed ESBL production whereas ESBL mediated resistance was low in community isolates. This study substantiated the need for planning proper antibiotic policy to reduce mortality due to Gram-negative sepsis.
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References
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