E-Coli and Klebsiella Pneumoniae

Abstract

Objectives: To evaluate extended spectrum betalactamase (ESBL) in E.coli andKlebsiella pneumoniae in bacterial cultures and its frequency at LRH. Study Design: Crosssectional analytical study. Setting: Lady Reading Hospital, Peshawar. Period: June 2013 toDecember 2013. Methodology: Total of 1037 bacterial isolates including 614 E.coli and 423 ofKlebsiellapneumoniae were evaluated. All cases were subjected to double disc diffusion methodfor ESBL detection using amoxacilln-clavulanic acid and a third generation cephalosporin asall ESBLs are hydrolysed by clavulanic acid. The data were analysed using SPSS-16. Results:Out of 1037 cases five ninety two (55%) were males and four fourty five (45%) were females. Ofthese, E. Coli were 614 (59.2%) and K. Pneumoniae were four twenty three (40.8%). Of these1037 isolates, four hundred & ninety five(47.7%) tested positive for ESBL enzyme. Frequencyof ESBL positivity in E.coli isolates was 264 (43%) and in Klebsiellapneumoniae isolates was231 (54.6%).Frequency of ESBL in pus was 34.3%(152/395),in urine, it was 31.8%(141/368),in blood it was 28.6%(127/233) and in sputum it was 5.1% (23/41). Unit wise frequency ofESBL was surgical & allied 24.6% (109/283), medical and allied 21.4%( 95/241), paediatrics18.5% (82/203), obstetrics & gynaecology 23.2%( 103/178) and outpatients 12.1 %(54/132).No significant correlation between ESBL positivity, gender, unit or specimen was found.Conclusion: ESBL positive isolates of E.coli and K.pneumoniaeshould be properly detected inroutine laboratory workflow to avoid unnecessary use of otherwise effective antibiotics.Theseresults indicate that such organisms are highly prevalent in our Hospital and need immediateinfection control measures to reduce their further spread.