Prevalence of ESBL producing Escherichia Coli and Klebsiella species with their co-resistance pattern to antimicrobials.

Extended spectrum ß-lactamase producing bacteria are potential emerging pathogens and continue to be a major challenge in clinical setup worldwide. In the present study an attempt was made to study the prevalence of extended spectrum ß-lactamase producing Escherichia coli and Klebsiella species from clinical isolates in a rural tertiary care hospital in West Bengal, India with their antimicrobial susceptibility as well as co-resistance pattern to different antimicrobials. A total of 179 Escherichia coli and 62 Klebsiella isolates recovered from various clinical samples of urine, pus, aural swabs and respiratory secretions (including sputum) for a period of six months were subjected to routine antimicrobial susceptibility testing and also tested for extended spectrum ß-lactamase production as per NCCLS recommendations. Extended spectrum ß-lactamase was detected in 32.40% of Escherichia coli and 40.32% of Klebsiella species isolates. Urine, pus and respiratory samples were common source of extended spectrum ß-lactamase producers and resistance rate of these organisms to third generation cephalosporins were more than 30 to 40%. Co-resistance pattern of these extended spectrum ß-lactamase producers to other commonly used antimicrobials were also statistically significant (p≤0.05). From the study it is concluded that indiscriminate use of third generation cephalosporins may be responsible for the selection of extended spectrum ß-lactamase producing multidrug resistant strains in hospital setup and amikacin is a reliable drug against them.

Detection of constitutive and inducible clindamycin resistance of staphlococcus in a rural tertiary care hospital.

Clindamycin has gained immense importance in the treatment of Staphylococcal infections following resistance to Beta-lactam antibiotics, especially after emergence of Methicillin Resistant Staphylococcus aureus. Clindamycin is a valuable treatment option for Staphylococcal isolates that are erythromycin resistant and clindamycin sensitive. However following exposure to erythromycin, clindamycin sensitive strains may lead to constitutive clindamycin resistance and treatment failure. But labeling all erythromycin resistant Staphylococci as clindamycin resistant strain prevents its use in infections caused by true clindamycin sensitive strains. This study aims to detect the presence of inducible clindamycin resistance among clinical isolates of Staphylococci. The detection of inducible clindamycin resistance was performed by D-Test as per the NCCLS guidelines. Among two hundred clinical isolates of Staphylococci studied, there was 24% inducible Clindamycin resistance among all the Staphylococci isolates: 29.4% among Methicillin Resistant Staphylococcus aureus and 21% among Methicillin Sensitive Staphylococcus aureus. It is advisable to include inducible clindamycin resistance testing as part of routine antimicrobial susceptibility testing.