Abstract

Background: Klebsiella species and Escherichia coli are members of the family Enterobacteriaceae encountered frequently as opportunistic pathogens in clinical settings. Cephalosporins are considered as first line drugs against Klebsiella species and Escherichia coli. Inappropriate use of β-lactams against gram negative bacteria has resulted in the widespread development of drug resistance. This study was done to know the prevalence of ESBL producing Klebsiella species and Escherichia coli among clinical isolates and to determine their antibiotic susceptibility patterns at Yenepoya Hospital, a tertiary care hospital. Materials and methods: A total of 200 isolates were obtained from clinical samples from April to June 2016. Samples were inoculated on MacConkey’s and blood agar. The organisms were identified based on standard microbiological procedures. Routine susceptibility testing was performed by Kirby Bauer’s disc diffusion method, as per the recommendations of CLSI. Following screening with Cefotaxime (30 μg) disc, resistance was then confirmed for ESBL production by phenotypic confirmatory disc diffusion test using Ceftazidime (30 ug) and Ceftazidime + Clavulanic acid (30 μg + 10ug) disc. Results: Out of 84 isolates of Escherichia coli and 116 isolates of Klebsiella species, 20(23.8%) and 26(22.4%) were ESBL producers respectively. These ESBL producers showed high degree of resistance to Ampicillin(100%) followed by Ceftazidime, Piperacillin and Cefotaxime for both Klebsiella species and E.coli. The most sensitive antibiotics were found to be Imipenem followed by Amikacin. Frequency distribution of ESBL producing E.coli and Klebsiella species was found to be highest among urine (42.5%) and sputum (25%)samples. Conclusion: The presence of ESBL producers has significant implications for patient management and indicates the need for regular and routine monitoring of ESBL producing clinical isolates in laboratory practices for proper disease management.

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