PHENOTYPIC EVALUATION OF PREVALENCE OF EXTENDED SPECTRUM BETA-LACTAMASES (ESBLs) PRODUCING UROPATHOGENS USING MODIFIED DOUBLE DISK SYNERGY TEST (MDDST) ALONG WITH THEIR ANTIBIOTIC SUSCEPTIBILITY PROFILE

NOOR JAHAN¹, RAZIA KHATOON²*
¹Department of Microbiology, Integral Institute of Medical Sciences and Research, Integral University, Lucknow, 226026, India
²Department of Microbiology, Hind Institute of Medical Sciences, Sitapur, 261303, Chhatrapati Shahu Ji Maharaj University, Kanpur, 208024, Uttar Pradesh, India
* Corresponding Author : drrazia@rediffmail.com

Received : 16-04-2018     Accepted : 24-04-2018     Published : 30-04-2018
Volume : 10     Issue : 4       Pages : 1147 - 1151
Int J Microbiol Res 10.4 (2018):1147-1151
DOI : http://dx.doi.org/10.9735/0975-5276.10.4.1147-1151

Keywords : extended spectrum beta-lactamases, modified double disk synergy test, prevalence, uropathogens
Conflict of Interest : None declared
Acknowledgements/Funding : Authors are thankful to Department of Microbiology, Hind Institute of Medical Sciences, Mau, Ataria, Sitapur, 261303, Chhatrapati Shahu Ji Maharaj University, Kalyanpur, Kanpur, 208024, Uttar Pradesh, India and Integral Institute of Medical Sciences & Research, Integral University, Lucknow, 226026, India
Author Contribution : Both authors have equally contributed

Urinary tract infections (UTIs) are probably the most common community acquired as well as nosocomial infections, mostly caused by Gram negative bacteria. Treatment of UTI cases is often started empirically, however, with the emergence of drug resistance among uropathogens in the form of extended spectrum beta-lactamases (ESBLs) production, treatment of such isolates has become quite difficult as these enzymes hydrolyze all penicillins, all cephalosporins (except cephamycins) and monobactams. Also, such organisms are often multidrug resistant and as the resistance genes are easily transferred from one organism to another via plasmids, their worldwide spread has become a threat to human population. Hence, the present study was done to determine the prevalence and antibiotic susceptibility profile of extended spectrum beta-lactamases producing uropathogens. A total of 156 consecutive, non duplicate gram negative bacilli recovered from urine samples were identified and their antibiotic susceptibility was tested. These isolates were first screened and then confirmed for ESBL production by modified double disk synergy test. Amongst 156 urinary isolates tested 69 were confirmed ESBL producers, with 8.7% (6/69 isolates) AmpC co-producers. The prevalence of ESBL was found to be 44.2%, with 61.3% among isolates from inpatients and 8.0% from outpatients. Maximum ESBL producers were Klebsiella pneumoniae (61.9%) followed by Escherichia coli (53.6%). All ESBL producers were 100% sensitive to imipenem, followed by sensitivity to nitrofurantoin (86.6%), piperacillin-tazobactam (81.2%) and norfloxacin (78.3%). To conclude routine ESBL testing for uropathogens along with conventional antimicrobial susceptibility testing should be done for deciding proper treatment of all cases of UTI

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