Background: Resistance to broad spectrum beta lactam antibiotics due to ESBL/AmpC/MBL enzymes is an increasing problem worldwide. Estimation of their prevalence in the area is essential to formulate an effective antimicrobial policy for a particular hospital/area. Aim: The present study was done to know the prevalence of ESBL/AmpC/MBL in gram negative organisms isolated from clinical samples and their susceptibility pattern in a tertiary care hospital in northern India. Methods: Total of 160 isolates of gram negative organisms from clinical specimens were screened for the presence of various beta lactamases by standard phenotypic methods and their antibiotic susceptibility pattern to conventionally used antibiotics was determined by disc diffusion method as per CLSI guidelines. Results: 118 gram negative isolates showing reduced susceptibility to third generation cephalosporin's were screened for ESBL/ AmpC/ MBL production. Beta lactamase production was seen in 74 out of the 160 gram negative isolates obtained from different samples. ESBL production alone or in combination with AmpC/MBL is seen in 60 isolates. ESBL/ AmpC and ESBL/ MBL coproduction was seen in 9 (5.6%) and 3 (1.9%) of the isolates respectively. Multi drug resistance was significantly higher in beta lactamase producers than non lactamase producers. Conclusions: There is need for continuous surveillance in the hospitals for the detection of various beta lactamases or resistant strains. Strict guidelines should be followed for antibiotic therapy so as to reduce burden of antibiotic resistance. Further phenotypic and genotypic studies should be undertaken to know the resistance pattern in bacteria.

Background and objectives: Nosocomial infections/Hospitalacquired infections (HAI) constitute an important problem worldwide accounting for high morbidity and mortality as well as longer hospital cost and stay. An intensive care unit (ICU) is often the epicenter of infection, due to its extremely vulnerable population. Consequently, ICUs have highest occurrence rates of nosocomial infections causing an enormous impact on health and often survival. This study was therefore aimed to know the prevalence and antibiotic susceptibility profile of various organisms causing HAI in ICUs of a Tertiary Care Hospital and Medical College. Materials and methods:A total of 847 consecutive samples mostly respiratory secretions, blood, and urine were collected from patients admitted in 6 ICUs of a tertiary care hospital and medical college from January 2017 to December 2017 and processed as per Clinical and Laboratory Standards Institute (CLSI) guidelines in the Microbiology department. Final identification and antimicrobial susceptibility testing of isolates were done by the automated Vitek 2 system.Results: Among the 847 samples processed 513 (60.5%) were positive for growth. Gram-negative organisms 366/513 (71.34%) were more commonly isolated than 147/513 (28.65%) Gram-positive organisms. Multidrug-resistant (MDR), Klebsiellapneumoniae, Acinetobacterbaumannii complex and Pseudomonasaeruginosa along with Extended-spectrum betalactamases (ESBL) producing Escherichia coli among Gramnegative organisms and methicillin-resistant Staphylococcus aureus (MRSA) and Vancomycin-resistant Enterococci (VRE) among Gram-positive were the most conspicuous findings. Conclusion:Our results showed higher resistance among all microorganisms in the ICUs compared to the rest of the hospital, the fact that highlights that ICUs should act as a critical point in the control of nosocomial infections.