KUMJ | VOL. 16 | NO. 2 | ISSUE 62 | APRIL-JUNE 2018
Extended Spectrum β-lactamase (ESBL) Producing Multi Drug Resistant (MDR) Urinary Pathogens in a Children Hospital from Nepal
Sharma KR, Bhandari P, Adhikari N, Tripathi P, Khanal S, Tiwari BR
Abstract: Background
Multidrug resistant in clinical bacterial isolates has increasingly been reported
through out the world and is associated with high morbidity, mortality and increased
health care costs. It is important to determine the status of multidrug resistance
pattern to understand the current resistance trend so that appropriate antibiotics
can be used in practice.
Objective
To determine the antibiotic resistant profile and prevalence of extended spectrum
β-lactamase producing multidrug resistant strains in pediatric patients of Kanti
Children’s Hospital, Kathmandu, Nepal.
Method
Urine sample was cultured by standard microbiological techniques and bacterial
isolates were identified using different biochemical tests. Antibiotic susceptibility
testing was performed by Kirby Bauer disc diffusion method and extended spectrum
β-lactamase detection was carried out using combined disc method as recommended
by Clinical Laboratory Standard Institute guidelines.
Result
All together 65 different bacteria were isolated and subsequently identified. E. coli
was the most common isolate with 46 (71%) isolates 63% of these isolates were
multidrug resistant. Gram negative isolates were most resistant to nalidixic acid
(81.97%) followed by ampicillin (69.35%) and co-trimoxazole (69.35%). The extended
spectrum β-lactamase producing isolates were 43% among total isolates.
Conclusion
Higher rate of Extended Spectrum β-lactamase production among multidrug resistant
isolates suggested routine extended spectrum β-lactamase testing in clinical isolates.
Keyword : Antimicrobial, Multidrug resistant, Urinary tract infection