Comparative Assessment of Antibiotic Susceptibility Pattern of Gram Negative Pathogens Isolated from Intensive Care Unit Patients in Pune

Abstract

Introduction and Aim: Extended spectrum β-lactamases (ESBLs) and Metallo-β-lactamases (MBLs) production is one of the main means of the resistance developed by Gram negative bacteria against β-lactam antibiotics. The present study was carried out to evaluate the incidences of ESBL and MBL producers in gram negative bacteria isolated from Ruby Hall Clinic, Pune, Maharashtra, India and to evaluate the efficacy of drugs against these bacteria. Methodology: 254 different samples collected from various sources were screened for the presence of bacterial pathogens. The pathogens were identified using selective media technique. The ESBL and MBL producer's screening and the antimicrobial susceptibility testing (AST) of pathogens towards a new drug; Elores (ceftriaxone + sulbactam with adjuvant ethylenediaminetetraacetic acid, EDTA) in comparison with commonly used antibiotics like meropenem, imipenem, piperacillin-tazobactam and cefoperazone-sulbactam was carried out according to CLSI guidelines.  Results: Among 254 samples collected, 200 samples showed the presence of bacterial infections with Klebsiella sp. (39%) as the most predominant pathogens followed by, E. coli (32%) and Pseudomonas sp. (16.5%), Acinetobacter sp. (12.5%). Of the identified pathogens, 61% (122/200) were found to be ESBL producers and 4.5% (9/200) were MBL producers. Nearly, 3.5% (7/200) pathogens were both ESBL and MBL producers. However another significant number (66 isolates) of pathogens were identified as non-ESBL/ non-MBL producers. Further, our data showed that, Elores was highly susceptible (87 to 100%) followed by imipenem-cilastatin (30 to 67%), meropenem (33 to 68%), cefoperazone-sulbactam (24 to 70%) and piperacillin-tazobactam (4 to 81%) against Gram negative bacteria. Conclusion: The results of the present study concludes, that Elores is an useful option to treat the infections caused by carbapenemase producing multi-drug resistance Gram negative bacteria.