Trends in Resistance to Extended-Spectrum Cephalosporins and Carbapenems among Escherichia coli and Klebsiella spp. Isolates in a District in Western India during 2004–2014

Abstract

Surveillance data on the level of resistant bacteria is needed to inform strategies to reduce the development and spread of antibiotic resistance. The aim of this study was to determine the non-susceptibility trends to extended-spectrum cephalosporins and carbapenems among Escherichia coli and Klebsiella spp. isolates from the district of Nashik in Western India during the period 2004–2014. Antibacterial susceptibility testing of clinical isolates was performed using Kirby-Bauer disc diffusion method to determine inhibitory zone diameters. The change in proportions of non-susceptible bacteria over calendar time was investigated with spline transformations in a logistic regression model. For the extended-spectrum cephalosporins, the proportions of non-susceptible E. coli and Klebsiella spp. isolates were above 78.4% and 84.9% throughout the study period, respectively. E. coli and Klebsiella spp. isolates exhibited carbapenem non-susceptibility levels as high as 76.9% and 84.1% respectively. The proportions of extended-spectrum betalactamase (ESBL)-producing isolates ranged from 38.3–85.9% in E. coli and from 45.1–93.1% in Klebsiella spp. Significantly higher proportions of non-susceptible and ESBL-producing isolates were found among isolates from inpatients compared to isolates from outpatients for both E. coli and Klebsiella spp. (p < 0.050). The high proportions of non-susceptible isolates observed show that there is great need to focus on optimal use of antibiotics to reduce the development of antibiotic resistance.

<p>The Existence of High Bacterial Resistance to Some Reserved Antibiotics in Tertiary Hospitals in Tanzania: A Call to Revisit Their Use</p>

“…22 The observed increased proportion of resistance could suggest extensive use of the antibiotic that leads to increase in resistance with time. 23 In this study, Enterococcus spp isolates were found in urine and blood samples thus posing risk for development of urinary tract and bloodstream infections respectively similar to what has been reported previously. 17 Most (88.9%) of the Enterococcus spp were resistant to clindamycin similar to the study by Sattari-Maraji et al who found the 96% resistance to clindamycin in Iran.…”

A 4-year Study of Community Acquired Urinary Tract Infections from a Tertiary Diagnostic Centre in Mumbai with Special Reference to MIC Values

“…• Aminoglycosides-Amikacin and Gentamicin showed good sensitivity of 92% and 69% respectively which is similar to study carried out by Bashini et al [7] and Sood et al [6]. • Nitrofurantoin, Cefoperazone sulbactum and Piperacillin tazobactum show higher susceptibility for E. coli as compared to Klebsiella and Pseudomonas isolates which is similar to study carried out by Edirisinghe et al [2] and Odsbuet et al [8]. • Carbapenem resistance in the isolates is a growing concern and hence drugs such as Ertapenem, Imipenem and Meropenem should be used judiciously.…”

The high resistance of bacteria to clindamycin and cefepime: a call to revisit antibiotics reserved for use at tertiary hospitals in Tanzania

“…Clindamycin is one of the potential alternative in high prevalent MRSA infections (25). The observed increased proportion of resistance could suggest extensive use of the antibiotic that leads to increase in resistance with time (26). In this study, Enterococcus spp isolates were found in urine and blood samples thus posing risk for development of urinary tract and bloodstream infections respectively similar to what has been reported previously(20).…”