PREVALENCE OF CEPHALOSPORIN-RESISTANT GRAM-NEGATIVE BACILLI FROM CLINICAL SAMPLES
Objective: Beta-lactams are the group of antibiotics that contain a ring called as beta-lactam ring,â€ which is responsible for the antibacterial activity.
The presence of resistance among Gram-negative organisms is due to the production of beta-lactamases enzymes that hydrolysis the beta-lactam ring
thereby conferring resistance to the organism. This study is undertaken to determine the prevalence of extended-spectrum beta-lactamase (ESBL)
producing Gram-negative organism from clinical samples.
Methods: A total of 112 clinical samples were taken for this study. The combined disc synergistic test (CDST) was used for the phenotypic detection
of ESBL producers from the clinical samples. The genotypic identification of ESBL producers was carried out by alkaline lysis method by isolation of
Result: A total of 87 bacterial isolates were isolated and identified. Among them, Klebsiella (41%) was the predominant organism followed by
Escherichia coli (33%), Proteus (10%), Pseudomonas (10%), and Serratia (6%). Among the various bacterial isolates, Klebsiella showed a higher
percentage of resistance. The CDST showed that 8 isolates of Klebsiella, 3 isolates of E. coli, and 1 isolate of Pseudomonas were found to be ESBL
producers. The genotypic confirmation showed that the two bacterial isolates, namely, Klebsiella and E. coli were found to possess temoniera (TEM)
gene which was the 400-500 bp conferring resistance to the antibiotics.
Conclusion: The results of this study suggest that early detection of ESBL producing Gram-negative organism is a very important step in planning the
therapy of patient in Hospitals. CDST continues to be a good indicator in the detection of ESBL producers.
Keywords: Beta-lactamases, Gram-negative bacilli, Extended-spectrum beta-lactamase, Resistance, Combined disc synergistic test.
1. Bradford PA. Extended-spectrum beta-lactamases in the 21st century:
Characterization, epidemiology, and detection of this important
resistance threat. Clin Microbiol Rev 2001;14(4):933-51.
2. Qureshi WK, Palayekar V, Dayan E, Mack JP, Rojtman A. Combating
the antibiotic resistance threat. Int J Pharm Pharm Sci 2015;7(2):68-72.
3. Samaha-Kfoury JN, Araj GF. Recent developments in beta-lactamases
and extended spectrum beta-lactamases. BMJ 2003;327(7425):1209-13.
4. Philippon A, Arlet G, Jacoby GA. Plasmid-determined AmpC Type
beta-lactamases. Antimicrob Agents Chemother 2002;46(1):1-11.
5. Paterson DL, Bonomo RA. Extended-spectrum beta-lactamases: A
clinical update. Clin Microbiol Rev 2005;18(4):657-86.
6. Mohanty S, Gaind R, Ranjan R, Deb M. Use of the cefepimeclavulanate
Etest for detection of extended-spectrum betalactamases
co-producing bacteria. J Infect Dev Ctries
7. Ben Slama K, Ben Sallem R, Jouini A, Rachid S, Moussa L, SÃ¡enz Y,
et al. Diversity of genetic lineages among CTX-M-15 and CTX-M-14
producing Escherichia coli strains in a Tunisian hospital. Curr
8. Pratibha JS, Manita TW. Antibacterial activity of honey against ESBL
producing Klebsiella pneumoniae from burn wound infections. Int J
Curr Pharm Res 2015;7(2):32-6.
9. Mehrgan H, Rahbar M. Prevalence of extended-spectrum betalactamase-producing
Escherichia coli in a tertiary care hospital in
Tehran, Iran. Int J Antimicrob Agents 2008;31(2):147-51.
10. Pfeifer Y, Cullik A, Witte W. Resistance to cephalosporins and
carbapenems in gram-negative bacterial pathogens. Int J Med Microbiol
11. Moosavian M, Deiham B. Distribution of TEM, SHV and CTX-M
genes among ESBL-producing Enterobacteriaceae isolates in Iran. Afr
J Microbiol Res 2012;6(26):5433-9.
12. Chong Y, Shimoda S, Yakushiji H, Ito Y, Miyamoto T, Kamimura T, et al.
Community spread of extended-spectrum beta-lactamase-producing
Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis: A longterm
study in Japan. J Med Microbiol 2013;62:1038-43.
13. Sandhiya R, Priya RL, Selvam E. Antibiotic susceptibility pattern and
ESBL prevalence in Escherichia coli isolates from pus samples in a
tertiary care hospital. Int J Pharm Pharm Sci 2015;7(3):263-4.
14. Riaz S, Bashir MF. Phenotypic and molecular characterization of
plasmid-encoded extended spectrum beta-lactamases produced by
Escherichia coli and Klebsiella spp from Lahore, Pakistan. Trop J
Pharm Res 2015;14(9):1597-604.
15. Kao CC, Liu MF, Lin CF, Huang YC, Liu PY, Chang CW, et al.
Antimicrobial susceptibility and multiplex PCR screening of AmpC
genes from isolates of Enterobacter cloacae, Citrobacter freundii, and
Serratia marcescens. J Microbiol Immunol Infect 2010;43(3):180-7.
16. Clinical Laboratory Standards Institute. Performance Standards for
Antimicrobial Susceptibility Testing. 22
CLSI Document; M100-S22. Wayne, PA, USA: CLSI; 2012.
17. Chandel DS, Johnson JA, Chaudhry R, Sharma N, Shinkre N, Parida S,
et al. Extended-spectrum beta-lactamase-producing gram-negative
bacteria causing neonatal sepsis in India in rural and urban settings. J
Med Microbiol 2011;60:500-7.
18. Sharma M, Pathak S, Srivastava P. Prevalence and antibiogram
of extended spectrum beta-lactamase (ESBL) producing gram
negative bacilli and further molecular characterization of ESBL
producing Escherichia coli and Klebsiella spp. J Clin Diagn Res
19. Behroozi A, Rahbar M, Yousefi JV. Frequency of extended spectrum
beta-lactamase (ESBLs) producing Escherichia coli and Klebseilla
pneumonia isolated from urine in an Iranian 1000-bed tertiary care
hospital. Afr J Microbiol Res 2010;4(9):881-4.
20. Rawat D, Nair D. Extended-spectrum beta-lactamases in gram negative
bacteria. J Glob Infect Dis 2010;2(3):263-74.
21. Mohamudha PR, Srinivas AN, Rahul D, Harish BN, Parija SC.
Molecular epidemiology of multidrug resistant extended-spectrum
beta-lactamase producing Klebsiella pneumoniae outbreak in a
neonatal intensive care unit. Int J Collab Res Intern Med Public Health
22. Pitout JD, Laupland KB. Extended-spectrum beta-lactamase-producing
Enterobacteriaceae: An emerging public-health concern. Lancet Infect
23. Sadasivam S, Manickam A. Biochemical Methods. 3
ed. New Delhi,
India: New Age International Publishers; 2008.
24. Zahar JR, Lortholary O, Martin C, Potel G, Plesiat P, Nordmann P.
Addressing the challenge of extended-spectrum beta-lactamases. Curr
Opin Investig Drugs 2009;10(2):172-80s.
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