Prevalence of extended spectrum beta lactamase (ESBL) production in gram negative isolates from pyogenic infection in tertiary care hospital of eastern Nepal.

Emergence of extended spectrum beta lactamase (ESBL) producing isolates has important clinical and therapeutic implications. A high prevalence of ESBL production among multidrug resistant gram negative isolates has been reported in literature from various clinical samples. Since ESBL detection is not done on a routine basis, its prevalence is not known till date. Thus the present study was undertaken to determine the prevalence of ESBL production in gram negative isolates from pyogenic infection. A total of 300 gram negative bacilli isolated from the pus samples were identified phenotypically and antimicrobial activity was determined. ESBL detection among the isolated organisms was done by Phenotypic confirmatory disc diffusion technique recommended by CLSI. Of the 300 isolates, majority were Escherichia coli; (107) followed by Acinetobacter species; (55), Pseudomonas species; (44), Klebsiella pneumoniae; (32), Proteus mirabilis; (26), Enterobacter species; (25), Citrobacter species; (9) and others; (2). The prevalence of ESBL producing organisms was found to be 54 (18%); amongst which Escherichia coli was 29 (53.7%), Klebsiella pneumonia (14.8%), Proteus mirabilis 7 (12.9%) and others 4 (7.4%). Multidrug resistance were found in 92.6% of ESBL producers. Forty two were resistant to all the three third generation cephalosporins. The continuous surveillance of the ESBL producing isolates is necessary to make aware about the correct treatment regimens and good infection control practices.