EXTENDED SPECTRUM β-LACTAMASE PRODUCING MULTIDRUG-RESISTANT KLEBSIELLA SPECIES ISOLATED AT NATIONAL MEDICAL COLLEGE AND TEACHING HOSPITAL, NEPAL
Abstract
Introduction: Extended spectrum β- lactamases (ESBL) producing multidrug resistant (MDR) Klebsiella species resulting in limitation of therapeutic option. The present study has been undertaken to detect the presence of extended spectrum β- lactamases producing multidrug resistant Klebsiella species in various clinical specimens.
Methodology: A total of 300 specimens including Urine, Pus and Blood were processed according to the standard methodology. Antibiotic susceptibility testing was done by Kirby Bauer disc diffusion method following Clinical and Laboratory standard institute (CLSI) guidelines. Combination disk method was done for the detection of extended spectrum β- lactamases producing isolates.
 Result: A total of 300 samples (200 urine, 45 bloods and 55 pus) were included in the study. Out of total samples proceed 110(36.7percent) samples showed significant growth of Gram-negative bacteria. Amongst these significant growth of 65(59.1percent) Klebsiella species, 45(69.2percent) Klebsiella pneumonia and 20(30.8percent) Klebsiella oxytoca were isolated. Amongst these total isolated Klebsiella species 30(66.7percent) multidrug resistant Klebsiella pneumonia and 9(45.0percent) multidrug resistant Klebsiella oxytoca were isolated. A total of 21(70.0percent) Klebsiella pneumonia isolates and 4(44.4percent) Klebsiella oxytoca isolates were found to be extended spectrum β- lactamases producers.
Conclusion: This study shows that Klebsiella pneumonia and Klebsiella oxytoca recovered from clinical specimens in this region produces extended spectrum β- lactamases in much higher number. Such isolates are also resistant to Floroquinolones, Aminoglycosides, Tetracycline and Cotrimoxazole. Further studies to investigate the factors which determine the emergence and persistence of multidrug resistant extended spectrum β- lactamases producing Klebsiella species in this region and their impact on clinical and economic outcomes at such institutions would be useful.
Keywords: Antibiotic susceptibility testing, MDR, ESBL, Combined disk assay,
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