DETECTION OF ESBL AND AMPC Β-Lactamases IN KLEBSIELLA SPP. AND EVALUATION OF RISK FACTORS IN a TERTIARY CARE HOSPITAL IN SOUTH INDIA

Abstract

BACKGROUND Multi-drug resistant strains of Klebsiella as a result of the production of β lactamases like ESBL and AmpC β lactamases pose a big problem. The aim of the study is to detect ESBL and AmpC β lactamases among Klebsiella spp. and to evaluate the risk factors associated with acquiring these beta lactamases. MATERIALS AND METHODS ESBL detection was done by the method advocated by the CLSI and AmpC production by the modified three-dimensional test. A detailed history was taken; therapeutic details and outcome were assessed. Statistical analysis was done by χ 2 test. Settings and Design-The isolates from samples of patients attending outpatient departments and admitted to wards and ICU of a tertiary care centre were included in study. RESULTS Among our isolates 104 (69.3%) were ESBL producers and 13 (8.6%) AmpC producers. Both ESBL and AmpC β lactamase production was seen in twelve isolates. There was significant association between hospital stay of more than 5 days, treatment with broad-spectrum antibiotics, admission to ICU/NICU and ESBL production. CONCLUSIONS The present study revealed a high rate of ESBL production and the coexistence of ESBL and AmpC. There is a need to devise and standardise more simple and reliable methods to detect them.