ABSTRACT
Background & Objectives: Extended-Spectrum Beta-Lactamase (ESBL) producing members of the family Enterobacteriaceae are emerging worldwide The aim of this study was to evaluate risk factors, co-morbidity status and short term mortality rates among hospitalized patients with and without ESBL producing Enterobacteriaceae spp. urinary isolates. Methods: An analytical cross-sectional study conducted in a super-specialty hospital from December 2014 to July 2015. Urine samples from 100 patients which repeatedly yielded significant colony counts of Enterobacteriaceae spp. isolates were identified using standard biochemical tests. Antibiotic susceptibility testing of these isolates was carried out by modified Kirby Bauer disk diffusion method as per CLSI guidelines 2014. Isolates which were resistant to cefotaxime and/or ceftazidime were tested for the production of ESBL by phenotypic confirmatory disc diffusion test. Relevant clinico-epidemiological details of these patients were subsequently obtained from Medical records as per the proforma formulated. The original version of the Charlson Index (CI) was used to assess co-morbidity and short term mortality rates. Results & Interpretation: Escherichia coli followed by Klebsiella pneumonia were the predominant isolates. 40 isolates were confirmed as ESBL producers. All isolates had Multiple Antibiotic Resistance (MAR) index of >0.2. The p-value of difference in proportion of all the risk factors distributed among patients with and without ESBL producing urinary Enterobacteriaceae spp. isolates respectively was found to be >0.05. The p-value of difference in mean Charlson index scores between these two groups of patients was 0.45. Conclusions: The results obtained in our study are largely inconclusive. It is imperative that more number of multicentre studies should be conducted in order to generate conclusive evidence on this subject. [Mohit B NJIRM 2016; 7(5):40-45]
ABSTRACT
A total of 94 bacteria, associated with wild Achanthobrama marmid (Heckel, 1843) in Sir Dam lake of Turkey identified. Subsequently, selected isolates were characterized and identified to the genus level. The 94 members of Enterobacteriaceae were isolated in the gills and intestines, and among the isolates, E. coli were represented at a rate of 55 %, Shigella spp. at a rate of 21 %, Salmonella spp. at a rate of 9%, Citrobacter spp. at a rate of 9%, Klebsiella spp. at a rate of 3% and Proteus spp., at a rate of 3%. A total of 94 bacteria resistant to antibiotics and heavy metals were isolated from total 47 of A. marmid samples and were investigated. Viable counts of antibiotic resistant bacteria isolated from gill and intestinal content samples showed high frequencies of resistance to Penicilline-G (KP) (68%), CZ (54%), FOX (48%), while the proportion of CRO (39%) and CTX (36%) resistance was low. In this research, heavy metal contamination in Sir Dam lake water samples and resistance frequency against heavy metals in isolated bacteria from gill and intestinal contents in A. marmid were investigated. Heavy metal contamination such as nickel (Ni), cadmium (Cd), copper (Cu) and chromium (Cr) determined diverse rate (except Mn) in water samples. The resistance frequency of the isolates was revealed different rate for the following heavy metals: Ni, Cd, Cu and Cr. When the concentration of heavy metals increased, the resistance against heavy metals in diverse genus of isolates in different rate decreased.