The Prevalence of ESBL among Enterobacteriaceae in a Tertiary Care Hospital of North Karnataka, India

Background and Objectives: Extended-spectrum beta-lactamase (ESBL) production in the members of the family Enterobacteriaceae can confer resistance to expanded-spectrum cephalosporins such as aztreonam and the penicillins. In the recent years, there has been an increased incidence and prevalence of ESBLs all over the world and also in various parts of India. As there was no data which was available on the prevalence of ESBL in this region and as multidrug resistance was rampant, the current study was undertaken to know the prevalence of ESBL producing Enterobacteriaceae at our tertiary health care centre. Aim: To know the prevalence of ESBL producing Enterobacteriaceae at our tertiary health care centre. Materials and Methods: This study was carried out on 218 clinical isolates of Enterobacteriaceae. The screening for ESBL production was done by the disc diffusion test which was recommended by the Clinical and Laboratory Standards Institute( CLSI) and the screen positive isolates were confirmed by the the double disc synergy test (DDST) and phenotypic disc confirmatory test (PDCT). Results: E. coli (57.8%) was most common isolate, followed by K. pneumoniae (25.6%). ESBL production was confirmed in 70(32.1%) isolates. The isolates of K. pneumoniae (46.4%) were the most common ESBL producers, followed by the isolates of E coli (31.7%) and others. ESBL production was most commonly seen in the Enterobacteriaceae which were isolated from the intensive care unit patients. Conclusion: There is a high prevalence of ESBL production in our hospital. Specific tests to detect ESBL production should be done routinely and an empirical therapy policy should be applied to the high risk units, based on the prevalence of the ESBL producing Enterobacteriaceae.