Detection of Extended Spectrum Beta Lactamases among Gram Negative Bacilli Isolated From Surgical Site Infection in a Tertiary Care Hospital

Abstract

Background: Surgical site infection (SSI) is a common complication that contribute to significant morbidity and mortality. The common organisms encountered in SSI are Staphylococcus aureus, Enterococci, E.Coli, Klebsiella spp and Pseudomonas. Knowledge of antibiotic susceptibility and drug resistant pattern will be of great help to treating physician and patient. This study is carried out to determine the prevalence of ESBL producing gram negative bacteria associated with SSI. Material & Methods: This is a prospective study carried out in a tertiary care hospital for a period of 2.5 years. 248 cases were diagnosed as having surgical site infection. Pus samples were processed for culture and antibiotic sensitivity. ESBL detection among gram negative bacteria was done by Predictor disk method and AmpC detection was done by AmpC disk test Result: Out of the 248 pus samples 221 were culture positive. Gram negative isolates171 (69.35%) were predominantly isolated as compared to gram positive86 (34.68%). Among the gram negative isolates 133(77.78%) were ESBL producer of which 33.33% were pure ESBL producer, 27.48% isolates shown both ESBL & AmpC production while 16.95% isolates were pure AmpC producer. These isolates were sensitivity to Imipenem & Amikacin. Conclusion: Present study indicated high prevance of ESBL producing bacteria associated with SSI. To prevent such type of infections change of antibiotic prophylaxis, screening for ESBL colonization, better infection control practices should be considered.