Bacteriological Profile of Gram-Negative Organisms from Cases of Septicemia and Their Antibiotic Sensitivity Pattern with Special Reference to Beta-Lactamase and Carbapenemase Production

Abstract

Background: Blood stream infections are amongst the most important causes of morbidity and mortality throughout the world. Septicemia is a serious bloodstream infection and a biggest challenge for the clinicians in selection of appropriate antimicrobial agents. Presence of intravascular catheters, immunosuppression and use of cytotoxic drugs are some precipitating factors for antibiotic resistance which is a global problem. Reports of multi-resistant bacteria causing septicemia in developing countries are increasing. Extended-spectrum beta-lactamases (ESBL) and Carbapenemase-producing Enterobacteriaceae (CRE) has caused a major public health concern. Aim and Objectives: To determine the bacteriological profile of septicemia and their antibiotic susceptibility profile with special references to β-lactamase and carbapemase productionin gram negative bacilli. Material and Method: During the 3 month period of study total 100 blood samples from suspected cases of septicaemia are collected. Isolates were processed and identified by standard protocols. Detection of extended spectrum β-lactamase (ESBL), inducible AmpC and MBL (Metallo β-lactamases) was done by using screening test and then confirmatory tests. Results: Out of 100 samples 68 gram negative organisms were isolated. Maximum growth was of Pseudomonas aeruginosa i.e. 34, followed by Klebsiella pnemoniae i.e. 19 and Acinetobacter sps and E.coli. From all isolates 4.4% were ESBL, Metallo –beta-lactamases (MBL) production were seen in 5.9 %. 40% and 10.5% were MBL-E.coli and MBL-Klebseilla pnuemoniae respectively. Conclusion: Many of the isolates from cases of septicaemia were resistant to most of the recently used antibiotics. So, Detection of the etiological agents and their antibiotic sensitivity will definitely help in effective prophylactic measures, prompt and accurate diagnosis of septicaemia. Simple methods like disc potentiation test for ESBL, disk antagonism test for inducible AmpC producers and Combined disk potentiation test for MBL production are relatively inexpensive and less cumbersome, so it can also be performed as a part of routine sensitivity testing. High degree of antibiotic resistance is an alarming sign for development of antibiotic policies and protocols for treatment of septicaemia.

Molecular detection of carbanemase in gram negative bacteria Isolated from intensive care unit patients Molecular detection of carbanemase in gram negative bacteria Isolated from intensive care unit patients in wasit province, Iraqin wasit province, Iraq

“…By the screening for MBL and Carbapenemase for the klebsiella pneumoniae were 9(47%) , similar results (42%) It was reported in another study [30]. The result of MBL and Carbapenemase for klebsiella oxytoca was 1(100%) compatible with the result [31] phenotype testing for carbapenemase production showed that the carbapenem-resistant isolates were positive MBL .Our study were results for pseudomonas aeruginosa was 7(35%) of MBL and Carbapenemase , similar results studies for MBL and Carbapenemase by [32] and [33] with (26.5%) and (37%) respectively .The result of MBL and Carbapenemase for E. Coli 7(43%) similar results (40%) .It was reported in another study [34]. By the screening for MBL and Carbapenemase for the Proteus mirabilis were 2(40%) similar results (50%) It was reported in another study [35].…”