Vol. 3, Issue 6 (2016)
A study of extended spectrum β-Lactamase (ESBL) producing Klebsiella from pus & urine samples from a tertiary care medical college hospital in Coimbatore
Author(s): Dr Shreeram A Deshpande, Nachammai SM, Kousalya Murugesan
Abstract: Urinary tract, gastrointestinal, and pyogenic infections are the common hospital-acquired infections caused by members of Enterobacteriaceae. Among Enterobacteriaceae, Klebsiella and Escherichia coli has been the most commonly isolated species. Klebsiella are very well known to exhibit multidrug resistance. β-lactamase production is perhaps the single most important mechanism of resistance to penicillins and cephalosporins. E. coli &Klebsiella possess a naturally occurring chromosomally mediated β-lactamase or plasmid mediated β-lactamases. These enzymes are thought to have evolved from penicillin binding proteins. This development was likely to be because of selective pressure exerted by β-lactam producing soil organisms found in the environment. In early 1960s, TEM-1 was the first plasmid mediated β-lactamase described in Gram-negative organisms. Another common plasmid mediated β-lactamase is SHV. Extended spectrum β-lactamases (ESBLs), enzymes that show increased hydrolysis of oxyimino-β-lactams, which include cefotaxime, ceftriaxone, ceftazidime, and aztreonam, have been reported increasingly in recent years. They belong to Ambler molecular class A and Bush–Jacoby functional group 2be. These enzymes have been identified in large numbers from different regions and are significantly detected in various E. coli &Klebsiella strains. They have also been found in other members of Enterobacteriaceae such as Citrobacter spp, Enterobacter spp, Proteus spp and non-lactose fermenters like Pseudomonas aeruginosa. Today over 200 different ESBLs have been described. Major outbreak involving these resistant organisms has been reported all over the world in many members of the Enterobacteriaceae and Pseudomonas spp, resulting in limitation of therapeutic options. Current knowledge of prevalence and incidence of ESBL production by commonly isolated organism such as E. coli and Klebsiella is necessary to understand the disease burden and to take necessary action to prevent the spread. Therefore the present study was conducted with an objective to find out the prevalence of ESBL producing Klebsiella and its antimicrobial resistance profile to formulate effective antibiotic strategy and plan a proper hospital infection control strategy to prevent the spread of these strains.