Detection and genetic characterization of extended-spectrum beta-lactamases producers in a tertiary care hospital

Suryarashmi Sahoo; Sarita Otta; Bichitrananda Swain; Subrat Kumar Kar

doi:10.4103/JLP.JLP_31_19

Journal of Laboratory Physicians, Inhaltsverzeichnis

CC BY-NC-ND 4.0 · J Lab Physicians 2019; 11(03): 253-258
DOI: 10.4103/JLP.JLP_31_19

Original Article

Detection and genetic characterization of extended-spectrum beta-lactamases producers in a tertiary care hospital

Autor*innen

Suryarashmi Sahoo

Department of Microbiology, Institute of Medical Sciences and SUM Hospital, S ‘O’ A University, Bhubaneswar, Odisha, India
Sarita Otta

Department of Microbiology, Institute of Medical Sciences and SUM Hospital, S ‘O’ A University, Bhubaneswar, Odisha, India
Bichitrananda Swain

Department of Microbiology, Institute of Medical Sciences and SUM Hospital, S ‘O’ A University, Bhubaneswar, Odisha, India
Subrat Kumar Kar

Regional Plant Resource Centre, Bhubaneswar, Odisha, India

Abstract

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Abstract

BACKGROUND: Extended-spectrum beta-lactamase (ESBL)-producing organisms inactivate extended beta-lactam antibiotics and monobactams and also exhibit coresistance to many other classes of antibiotics. The present study was carried out to assess the prevalence of the ESBLs and to determine the most prevalent genotype in our hospital.

MATERIALS AND METHODS: All clinically significant Gram-negative isolates were identified, and their antimicrobial susceptibility testing was done by Kirby–Bauers' disc diffusion method. ESBL detection was confirmed by minimal inhibitory concentration method using agar dilution technique for those who screened positive by ceftazidime (30 μg) disc. Further, the established ESBL-positive isolates were subjected to genotyping for bla TEM, bla CTX-M, and bla SHV genes by using conventional polymerase chain reaction.

RESULTS: Escherichia coli was the most common (28.84%) Gram-negative bacillus followed by Klebsiella pneumoniae (18.07%), while Pseudomonas spp. (9.61%) was the most commonly identified nonfermenter. ESBL production was detected in 160 (30.8%) isolates. Klebsiella oxytoca (46.7%) followed by E. coli (44%) were the common ESBL producers. Most predominant ESBL gene was bla TEM, found in 122 (76.25%) isolates. Combinations of two genes were seen in 109 (68.1%) isolates, the most common (43.12%) combination being bla_TEM and bla_CTX-M. In this study, 16 (10%) strains had all the three types of genes. Most of the isolated Gram-negative bacilli (GNB) were sensitive to amikacin, imipenem, and colistin.

CONCLUSION: In our study, the 30.8% of GNB were ESBL producers. This is the only study that shows that TEM is the most prevalent ESBL genotypes in our area. Of concern is a good number of isolates showing all three patterns of genes (TEM, SHV, and CTX-M). Amikacin, imipenem, and colistin were the most useful antibiotics in our setup.

Key words

Bla TEM - extended-spectrum beta-lactamase - genotyping

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Referenzen

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