Prevalence of ESBL in Klebsiella Sp. and Its Antibiotic Resistance Pattern from Various Clinical Samples in a Tertiary Care Hospital

Abstract

Background: Klebsiella infection presents a global medical challenge because it is an important opportunistic GNB in health care institutions. The isolation and identification of resistance pattern of Klebsiella infections helps in selection of appropriate antibiotics, reducing the morbidity and mortality of patients and reducing the spread of resistant strains in the community Objective: The present study was carried out to investigate the prevalence of ESBL in Klebsiella species and its antibiotic resistance pattern from various clinical samples. Method: Specimens like urine, blood, sputum, pus, wound swab, tracheal aspirates Microbes from urine, blood, sputum, pus, wound swab, and tracheal aspirates after preparation and cultivation, and isolation were identified by Gram’s staining and various biochemical reactions. Antibiotic susceptibility testing was done including third generation cephalosporins and the resistant were done by Double disc synergy test (DDST) and Combined disc diffusion test (CDDT). Result: Klebsiella pneumoniae subsp. aerogenes (48%) was the most common species isolated followed by Klebsiella oxytoca (46%), Klebsiella pneumoniae subsp pneumoniae (6%). Among 100 isolates of Klebsiella spp., 53(53%) isolates were ESBL producers. Of the 53(53%) ESBL isolates, 46(46%) isolates showed ESBL production by double disk synergy test and 51(51%) by combined disk diffusion test. Conclusion: Most of Klebsiella ESBL positive isolates were observed in pus sample. Combined disc diffusion test demonstrated more effectivity than double disc diffusion test. So, CDDT being simple and cheaper method should be included in the microbiology laboratories as a routine test for early deduction of ESBL producing organisms in specimen from critically ill patients.