Evaluation Of Charlson’s Co-Morbidity Index And Risk Factors Among Patients With And Without Extended Spectrum Β-Lactamase Producing Enterobacteriaceae Spp. Urinary Isolates In A Super-Specialty Hospital.

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]