Extended spectrum beta lactamase (ESBL) mediated resistance to third generation cephalosporins among Klebsiella pneumoniae in Chennai.

PURPOSE: To examine the incidence of extended spectrum b lactamase (ESbL) producing strains and multidrug resistant strains of Klebsiella pneumoniae isolated from children between 0-5 years of age.
METHODS: Multidrug resistance and ESbL production was studied in a total of 120 isolates of Klebsiella pneumoniae obtained from patients aged 0-5 years.
RESULTS: 95% of the isolates showed resistance or decreased susceptibility to at least one of the three third generation cephalosporins [3GC (ceftazidime, cefotaxime, ceftriaxone)] used for the study. 87% of the isolates showed resistance to all the three 3GC antibiotics and this resistance to all the three 3GC was found to coexist with resistance to other antibiotics. All the isolates were found sensitive to the antibiotic imipenem. ESbL production was detected in 8 strains of Klebsiella pneumoniae. The ESbL activity could be experimentally transferred to recipient E. coli (K12 J62-2). Resistance to b-lactam antibiotics was co-transferred with resistance to gentamicin.
CONCLUSIONS: This study has shown the incidence of ESbL producing Klebsiella pneumoniae strains among children in Chennai. Tests for the detection of ESbL producing Klebsiella strains should be carried out in all diagnostic centers routinely and the therapeutic use of all the 3GC should be avoided against Klebsiella strains that appear resistant to any third generation antibiotic.