PREVALENCE AND ANTIMICROBIAL SUSCEPTIBILITY PATTERN OF EXTENDED SPECTRUM BETA LACTAMASE PRODUCING KLEBSIELLA PNEUMONIAE ISOLATED FROM RESPIRATORY SAMPLES IN A SOUTH INDIAN TERTIARY CARE HOSPITAL

Objective: Klebsiella pneumoniae is important in causing a classic form of primary pneumonia and the leading causes of nosocomial infection, being hard to eradicate due to development of multidrug-resistant strains that produce extended–spectrum beta-lactamase (ESBL) enzyme. The present study was conducted to find out the prevalence and antimicrobial susceptibility pattern of respiratory isolates of ESBL producing Klebsiella pneumoniae at our hospital . Methods: Respiratory samples of RTI patients from different IPDs and OPDs sent for culture and sensitivity prior to starting of any antibiotics, during January 2012 to June 2013 were included in the study. Klebsiella pneumoniae was identified by standard laboratory procedure as per CLSI guideline. Antimicrobial susceptibility testing was done by Kirby-Bauer’s disk diffusion method in Mueller Hinton Agar media. ESBL producing strains were confirmed by Double Disk Synergy test after initial screening with 3rd generation cephalosporins. Results: Out of 400 respiratory samples ,140 Klebsiella pneumoniae were isolated among which 38 ( 27.14 % ) were ESBL producers and 102 ( 72.86 % ) were non ESBL strains . A 131 ( 93.57% ) isolates were obtained from IPDs. and 9 ( 6.43 %) were from OPDs .Male to female ratio for ESBL producing K. pneumonia was 1.7 : 1. TBCD dept. and ICCU were the major contributors of those positive isolates. A 64% multi drug resistance were observed among ESBL isolates. Apart from 3rd generation cephalosporins, they were also highly resistant to common antibiotics like Ampicillin, Aztreonam, Gentamycin, Erythromycin and Co-trimoxazole. Imipenem was the most active antibiotics with 96.37% susceptibility rates. Conclusions: Regular monitoring on the judicious use of antibiotics helps in preserving the effectiveness and emergence of further resistance of the sensitive antibiotics among the ESBL producing K. pneumonia.