Antimicrobial susceptibility testing and ESBLdetection from the bacteria in haemodialysis patients

ABSTRACT

To find out the antimicrobial sensitivity and extended spectrum beta-lactamase producing organisms among clinical isolates recovered from patients on haemodialysis. Extended spectrum beta-lactamase are enzymes produced from some strains of gram negative bacilli that mediate resistance to extended spectrum cephalosporin and aztreonam. They are most common in E.coli and Klebsiella species but are present in variety of enterobacteriacea. Experimental and observational study. This study was carried out in Microbiology Department of BMSI, JPMC, Karachi. This study was carried out from June 2005 to June 2006. A total of 250 cases irrespective of age and gender were included in this study. A total of 15 gram positive cocci [7.5%] and 175 [87.5%] gram negative organisms were recovered. In this study 66.66% E.coli and 33.33% Klebsiella species were ESBL producing. Antimicrobial sensitivity pattern in this study show that most of the organisms were sensitive to 2[nd] and 3[rd] generation cephalosporins and fluroquinolones i.e. ciprofloxacin. Table 1 shows isolation of ESBL producing organisms from 200 positive cases. Out of these 175 cases were from Enterobacteriaceae, among these 06 [3.42%] cases have been found to be ESBL producing organisms. The results of this study support the use of initial antimicrobial therapy to reduce the spread of infection and other complications. Currently ciprofloxacin is regarded as the drug of choice for the treatment of infection caused by both gram negative and gram positive bacteria in patients on hemodialysis