Antibiotic Therapy for ESBL and NDM producing Escherichia coli and Klebsiella pneumoniae isolates in a Tertiary Care Center
Objective: Antibiotic resistance is a global phenomenon wherein
physicians face the most challenging decision to make for the right kind of
drug, and its combinations, to tackle the ever growing ESBL and NDM on
pathogens. The aim of the study is to understand outcome of hospitalized
patients undergoing antibiotic therapy for bacterial infections. These patients
are from Kamrup District of Assam, India.
Materials
and methods: A total of 185 clinical isolates of Escherichia coli and Klebsiella
pneumoniae were collected from hospitalized patients of a tertiary care
centre presenting symptoms of infection. Upon biochemical identification, their
antibiotic susceptibility were assessed; isolates resistant to 3rd or 4th
generation cephalosporins or carbapenem were phenotypically and genotypically
determined for the production of extended spectrum β-lactamase (ESBL) and
carbapenemase. PCR was carried out for CTX-M, TEM, SHV, OXA-48 and New Delhi
Metallo-β-lactamase (NDM).
Results:
Bacterial infection is ubiquitous among male and female patients, with high
isolation rate of Escherichia coli
among female patients with urinary infection. The highest resistance against E. coli isolates was nalidixic acid
(82.9%; p≤0.005) and cefixime (81.4%; p≤0.005). The highest resistance against K. pneumoniae was cefotaxime (77.7%;
p≤0.005) and ceftazidime (73%; p≤0.005). Imipenem was the most effective
antibiotic while ertapenem was the least. Antibiotic therapy included
piperacillin (alone or in combination with tazobactam) for both E. coli and K. pneumoniae infections.
Conclusions: Ceftriaxone, amikacin, cefepime, ceftriazone and
imipenem were chosen as treatment options; isolates showed intermediate to
negligible resistance to these drugs. Tigecycline was administered to patients
infected with NDM producing pathogens. J Microbiol Infect Dis 2018; 8(4): 153-157.
Keywords:
antibacterial agents drug resistance, ESBL, NDM,
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- ISSN: 2146-3158
- Başlangıç: 2011
- Yayıncı: Sağlık Araştırmaları Derneği