Antibiotic Therapy for ESBL and NDM producing Escherichia coli and Klebsiella pneumoniae isolates in a Tertiary Care Center

Authors : Vedant Vikrom BORAH, Mrinal Kumar BAİSHYA, Kandarpa Kr SAİKİA

Pages : 153-157

Doi:10.5799/jmid.493854

View : 39 | Download : 6

Publication Date : 2018-12-15

Article Type : Research Paper

Abstract :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 insert ignore into journalissuearticles values(ESBL); and carbapenemase. PCR was carried out for CTX-M, TEM, SHV, OXA-48 and New Delhi Metallo-β-lactamase insert ignore into journalissuearticles values(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 insert ignore into journalissuearticles values(82.9%; p≤0.005); and cefixime insert ignore into journalissuearticles values(81.4%; p≤0.005);. The highest resistance against K. pneumoniae was cefotaxime insert ignore into journalissuearticles values(77.7%; p≤0.005); and ceftazidime insert ignore into journalissuearticles values(73%; p≤0.005);. Imipenem was the most effective antibiotic while ertapenem was the least. Antibiotic therapy included piperacillin insert ignore into journalissuearticles values(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; 8insert ignore into journalissuearticles values(4);: 153-157.
Keywords : antibacterial agents, drug resistance, ESBL, NDM

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