IJCRR - Vol 08 Issue 11, June, 2016
COMPARISON OF DIFFERENT PHENOTYPIC METHODS FOR THE DETECTION OF EXTENDED SPECTRUM b- LACTAMASE (ESBL) IN BACTERIAL ISOLATES FROM TERTIARY CARE CENTRE
Author: Shaikh N. K., Mundhada S. G., Lalngaihzuali R., Ingole K. V.
Background and objective: Extended spectrum β lactamases (ESBLs) continue to be a major problem in clinical setups. Their detection is essential for proper antibiotic therapy, to limit the spread of resistance mechanisms and for epidemiological purposes. The objective of our study was to compare different phenotypic methods for detection of ESBL to know the best suitable one in our setup.
Material and method: A total of 127 Gram negative isolates were identified by standard protocol and Antibiotic susceptibility testing (AST) was done. Isolates which were resistant to one of the third generation cephalosporins were selected provisionally as ESBL producers and then subjected for confirmation by Phenotypic confirmatory disc diffusion test (PCDDT), Double disk synergy tests, Modified double disk synergy test (MDDST), Indirect modified three dimensional test (IMTDT) to evaluate their ability to detect ESBLs. Minimal inhibitory concentration (MIC) by the agar dilution method was used as the standard reference method.
Result: MIC detection by agar dilution method had confirmed all 63(49.60%) screening positive isolates as ESBL producers. E.coli which constitute 39(61.90%) of the isolates was found to be highest ESBL producer among them. PCDDT by CLSI detected ESBL in 55(87.30%) isolates. DDST using amoxicillin-clavulanic acid detected the same in 49 (77.78%) cases. MDDST using cefepime and piperacillin-tazobactam detected ESBL in 60(95.23%) cases. IMTDT detected 62(98.41%) ESBL producing isolates.
Conclusion: IMTDT was found to be superior method than MDDST, PCDDT and DDST for detection of production of ESBL alone or in presence of other β- lactamases like Amp C.
Keywords: Amp C, DDST, ESBL, IMTDT, MDDST, PCDDT
Shaikh N. K., Mundhada S. G., Lalngaihzuali R., Ingole K. V.. COMPARISON OF DIFFERENT PHENOTYPIC METHODS FOR THE DETECTION OF EXTENDED SPECTRUM b- LACTAMASE (ESBL) IN BACTERIAL ISOLATES FROM TERTIARY CARE CENTRE International Journal of Current Research and Review. Vol 08 Issue 11, June, 10-14
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