Trend In Susceptibility Pattern To Commonly Used Antibacterial Agents And Role Of Ceftriaxone+Sulbactam+Disodium Edetate Combination Against Extended Spectrum Beta-Lactamase And Carbapenemase Producing Gram Negative Isolates

Research Article
K Prasanthi K Nagamani, PR Anuradha1 and DS Murty
Gram negative bacteria, Drug resistance, ESBL, micro-broth dilution, Elores

In the present study, we attempted to find the resistance pattern to antibacterial agents among extendedspectrum beta-lactamases (ESBL) and carbapenemase positive isolates, obtained from different clinical specimens at Gandhi Medical College Hospital, Hyderabad, India. A total of 299 isolates consisting of 250 ESBL and 49 carbapenemase producing isolater were recovered from various samples collected from intensive care units (ICU) and wards. Antibiotic susceptibility study was done by the disc diffusion method according to the Clinical Laboratory Standards Institute guidelines. Out of 299 isolates, 281 (93.9%) were of Enterobacteriaceae family and 18 (6.0%) were from non-Enterobacteriaceae. Of Enterobacteriaceae family, 184 (65.5%) were E. coli and 97 (34.5%) were K. pneumoniae. Among non-Enterobacteriaceae, 9 of each were Acinetobacter spp and P. aeruginosa. The most prevalent pathogen was E. coli followed by K. pneumoniae, and equal prevalence of Acinetobacter spp and P. aeruginosa. Ceftriaxone+sulbactam+disodium edetate (Elores) was the most effective drug showing100 % susceptibility to P. aeruginosa followed by E. coli (88.4%), K. pneumoniae (78.0%), Acinetobacter spp (66.6 %). The comparator drugs showed low sensitivity up to 55.0%. Carbapenemase producers, showed 100% resistance to Meropenem. However, Elores showed sensitivity ranging from 50.0% to 58% in carbapenemases producing E.coli, K. pneumoniae and P.aeruginosa. This study provides important data for clinicians to plan the appropriate treatment regimen. As Elores showed better activity against both Enterobacteriaceae and non- Enterobacteriaceae family pathogens, it may be a useful option to treat the infections caused by these organisms.