Study of extended spectrum β-lactamase producing Enterobacteriaceae and antibiotic coresistance in a tertiary care teaching hospital

AIMS: To study the prevalence of extended spectrum β-lactamase (ESBL) producing Enterobacteriaceae and coresistance to other commonly used antibiotics from the Bhopal region of Central India. SETTINGS AND DESIGN: A prospective study was conducted from September 2011 to August 2012 in Microbiology Department of our tertiary health care center. MATERIALS AND METHODS: A total of 1044 Enterobacteriaceae isolates were recovered from various specimens. ESBL production was detected by using Clinical Laboratory Standard Institute (CLSI) that described the phenotypic confirmatory test along with routine antibiotic susceptibility testing. STATISTICAL ANALYSIS: Two-tailed Z-test. RESULTS: Escherichia coli was the most common isolate (65.32%). ESBL production was confirmed in 504 (48.27%) isolates. The isolates of E. coli (50.14%) were the most common ESBL producers. Maximum ESBL isolates were obtained from urine samples (52.28%) and male patients (52.54%). Sensitivity to imipenem was 100% followed by piperacillin–tazobactam (89.28%), meropenem (87.5%), and amikacin (83.92%). Significant resistance was detected against trimethoprim–sulfomethoxazole, fluoroquinolones, and gentamicin. CONCLUSION: This is the only study conducted from Central India and shows high prevalence of ESBL production among Enterobacteriaceae. Imipenem seems to be more sensitive than meropenem. Piperacillin–tazobactam combination was found to be the best among the β-lactam–β-lactamase inhibitor combinations. Prevalence of ESBL producers were more in males than females.