Extended-Spectrum β-lactamase Production among Enterobacter cloacae and Enterobacter aerogenes at a Tertiary Care Center in Coastal Karnataka

Abstract

Introduction: Enterobacter spp. have been increasingly isolated as nosocomial pathogens. Multi-drug resistance is more frequently noted among these pathogens. Extended spectrum beta lactamases (ESBLs) are difficult to detect in Enterobacter spp. as they also produce inducible AmpC chromosomal enzymes. Aim: To study the frequency of ESBL production among clinical isolates of Enterobacter spp. by modified double disc potentiation test. Materials and Methods: A prospective study was conducted to analyse the susceptibility profile and to detect ESBL production among 54 Enterobacter isolates obtained from various clinical specimens by a phenotypic modified double disc potentiation test to demonstrate synergy between cefepime and amoxicillinclavulanate discs. Results: A significant proportion of Enterobacter spp. was found to produce ESBLs (44.4%). ESBLs were detected in higher frequency in E. cloacae (48.9%) as compared to E. aerogenes (14.3%). Imipenem (96.3%) and amikacin (92.6%) were the most effective antibiotics. Conclusion: Considering the high rates of multi-drug resistance, it is necessary for both clinicians and microbiologists to recognize the clinical and antimicrobial profile of Enterobacter spp. so that effective measures may be adopted to control their spread.

Keywords

• ampc
• cefepime
• phenotypic
• susceptibility