Abstract

TO STUDY THE PREVALENCE OF ESBL AND MBL PRODUCING GRAM NEGATIVE BACILLI FROM VARIOUS CLINICAL SAMPLES AT TERTIARY CARE HOSPITAL

Antimicrobial resistance pattern and resistance to third generation cephalosporins has become increased worldwide. The detection of extended spectrum lactamases (ESBLs) and metallobetalactamases (MBLs) among members of Enterobacteriaceae family guide us to use Beta lactam, if not tested leading to treatment failure. Materials and methods: Six months prospective study was conducted during July 2022 to December 2022, our aim is to detect ESBL and MBL producing gram negative bacilli from various clinical samples. A total of 100 Gram negative bacilli were processed. ESBL was detected by phenotypic confirmatory disc diffusion test (PCDDT) using Ceftazidime / Cefotaxime alone and in combination with clavulanic acid. MBL detection was done by Imipenem EDTA combined disc diffusion test (CDDT), double disc synergy test (DDST) and Modified Hodge test. Results: Out of 100 isolates, 49 (49%) were ESBL producers, 21 (21%) were MBL producers and 13(19%) isolates were both ESBL and MBL producers. ESBL production was observed in Escherichia coli, Klebsiella pneumoniae, Pseudomonas spp and Citrobacter spp and MBL production was observed in Pseudomonas aeurginosa, Acinetobacter spp, Escherichia coli, Klebsiella spp from various clinical samples. Among the 49 ESBL producers, 97% of the isolates showed resistance to any one of the third generation cephalosporin (ceftazidime, cefotaxime, ceftriaxone) and 3% showed resistance to all the three third generation cephalosporin. Among 21 MBL producers, 14 (67%) were MBL producers by CDDT whereas 7 (33%) by DDST methods. Conclusion: Introduction of simple, reliable and reproducible screening tests for early detection and identification of ESBL and MBL producing gram negative bacilli in routine diagnostics is of crucial important to prevent nosocomial dissemination of resistance. In our study we found that CDDT is the most sensitive method among three phenotypic methods (CDDT, DDST, and Modified Hodge Test) for detection of MBL