ESBL producing Pseudomonas aeruginosa in clinical specimens: Is it a scary nightmare or paper tiger?

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Original Article

Author Details : Nithyalakshmi J, Vidhyarani R, Mohanakrishnan K, Sumathi G

Volume : 3, Issue : 3, Year : 2016

Article Page : 287-291

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Abstract

Background: Pseudomonas aeruginosa well known as opportunistic pathogen, has been implicated in life threatening nosocomial infections in recent years. This can be attributable to acquired resistance by plasmid mediated different types of extended spectrum beta lactamases(ESBL). The present study was undertaken to detect the ESBL production of Pseudomonas aeruginosastrains and analyze their susceptibility pattern.
Methods: Various clinical specimens received in our laboratory were processed and Pseudomonas aeruginosa was identified as per standard microbiological procedure. A total of 132 clinical isolates of Pseudomonas aeruginosa identified during the study period were included in the study. All isolates were subjected for ESBL screening test. Potential ESBL producer was then subjected for ESBL Phenotypic confirmatory test –Disc Diffusion method(PCDDT). Antimicrobial susceptibility test was performed by Kirby – Bauer disc diffusion method on all confirmed isolates by PCDDT method as per Clinical Laboratory Standard Institute (CLSI 2016) guidelines.
Results: By phenotypic confirmatory method, the frequency of occurrence of ESBL among the isolates identified was 21.96% (n = 29).The highest number of ESBL producers was obtained from urine samples(27.7%) followed by respiratory infection (23.68%) and wound infection (22.95%). In-vitro susceptibility of ESBL producers revealed high level of resistance to third generation cephalosporin. Low resistance was observed to Imipenem (3.4%) and Piperacillin – Tazobactam (13.79%).
Conclusion: Our study highlights the unique challenge imposed by Pseudomonas aeruginosa as the therapeutic choices are limited by ESBL production. To overcome this issue, we recommend routine ESBL detection and surveillance of antibiotic resistance in hospital settings.

Keywords: Pseudomonas aeruginosa, ESBL, Third generation cephalosporins, Imipenem, Urine, ESBL Screening test

How to cite : Nithyalakshmi J, Vidhyarani R, Mohanakrishnan K, Sumathi G, ESBL producing Pseudomonas aeruginosa in clinical specimens: Is it a scary nightmare or paper tiger?. Indian J Microbiol Res 2016;3(3):287-291

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