ABSTRACT:
OBJECTIVES: Wide spread use of ß lactam antibiotics has lead to resistance to these group of antibiotics in bacterial pathogens due to various types of ß lactamase production. Klebsiella pneumoniae harboring Extended spectrum ß lactamase (ESBL)) and carbapenemases are a serious problem worldwide. Klebsiella pneumoniae is an established pathogen responsible for multidrug resistant hospital acquired infections. Our study was undertaken to detect prevalence of ESBL and KPC producing Klebsiella spp in a tertiary care hospital and to check their antibiotic resistance pattern by phenotypic methods recommended by CLSI. METHODS: A total of 120 non enteric clinical isolates klebsiella spp were speciated and antibiotic sensitivity was determined by Kirby Bauer disc diffusion method. Isolates found to be screen positive for possible ESBL and carbapenemase production were further confirmed by phenotypic confirmatory methods recommended by CLSI. RESULTS: I09 isolates were found to be screen positive for ESBL, out of which 29 isolates (27%) were confrmed ESBL producer by combined disc method. A total of 11 isolates were found to be screen positive for carbapenemase production out of which 4 (36%) were confirmed carbapenemase (KPC) producer by Modified Hodge test (MHT). All the ESBL and carbapenemase producing Klebsiella isolates were found to be multidrug resistant (MDR). 93% (27/29) ESBL positive isolates were sensitive to imipenem. ESBL producers also showed coresistance to amikacin 52% (15/29), ciprofloxacin 41% (12/29).Two carbapenemase producing 2 isolates were highly resistant and found to be sensitive to only colistin and tigecycline. CONCLUSION: Failure to detect MDR organisms like ESBL and KPC producers on time may lead to outbreak of hospital acquired infections by such strains. So clinical laboratories should routinely do such easy to perform screening tests to detect these resistance mechanisms.