Open AccessSurveillance of ESBL producing multidrug resistant Escherichia coli in a teaching hospital in India
Author(s) -
Shakti Rath,
Debasmita Dubey,
Mahesh Chandra Sahu,
Nagen Kumar Debata,
Rabindra N. Padhy
Publication year - 2014
Publication title -
asian pacific journal of tropical disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.208
H-Index - 33
ISSN - 2222-1808
DOI - 10.1016/s2222-1808(14)60331-5
Subject(s) - antibiotics , gentamicin , medicine , multiple drug resistance , antibiogram , drug resistance , microbiology and biotechnology , beta lactamase , antibiotic resistance , intensive care unit , escherichia coli , emergency medicine , biology , gene , biochemistry
Objective: To record nosocomial and community-acquired accounts of antibiotic resistance\udin Escherichia coli (E. coli) strains, isolated from clinical samples of a teaching hospital by\udsurveillance, over a period of 39 months (November 2009-January 2013).\udMethods: Clinical samples from nosocomial sources, i.e., wards and cabins, intensive care\udunit (ICU) and neonatal intensive care unit (NICU), and community (outpatient department, OPD)\udsources of the hospital, were used for isolating strains of E. coli, which were subjected for testing\udfor production of ‘extended spectrum beta-lactamase’-(ESBL) enzyme as well as determining\udantibiotic sensitivity pattern with 23 antibiotics.\udResults: Of the total 1642 (100%) isolates, 810 (49.33%) strains were from OPD and 832 (50.66%)\udwere from hospital settings. Occurrence of infectious E. coli strains increased in a mathematical\udprogression in community sources, but in nosocomial infections, such values remained almost\udconstant in each quarter. A total of 395 (24.05%) ESBL strains were isolated from the total 810\udisolates of community; of the total of 464 (28.25%) isolates of wards and cabins, 199 (12.11%) were\udESBL strains; and among the total of 368 (22.41%) isolates of ICU and NICU, ESBLs were 170 (10.35%);\udthe total nosocomial ESBL isolates, 369 (22.47%) were from the nosocomial total of 832 (50.66%)\udisolates. Statistically, it was confirmed that ESBL strains were equally distributed in community\udor hospital units. Antibiogram of 23 antibiotics revealed progressive increases of drug-resistance\udagainst each antibiotic with the maximum resistance values were recorded against gentamicin:\ud92% and 79%, oxacillin: 94% and 69%, ceftriaxone: 85% and 58%, and norfloxacin 97% and 69%\udresistance, in nosocomial and community isolates, respectively.\udConclusions: This study revealed the daunting state of occurrence of multidrug resistant E. coli\udand its infection dynamics in both community and hospital settings