N G Manjula, C Math Girish, Nagshetty Kavita, Patil Shripad A, Gaddad Subhashchandra M, Shivannavar Channappa T
Research Scholar, Department of Post Graduate Studies and Research in Microbiology, Gulbarga University , Gulbarga, India .
Guest Faculty, Department of Post Graduate Studies and Research in Microbiology, Gulbarga University , Gulbarga, India .
J Clin Diagn Res. 2014 Oct;8(10):DC08-11. doi: 10.7860/JCDR/2014/9594.5048. Epub 2014 Oct 20.
Klebsiella pneumoniae possess a new problem to health care professionals worldwide, which complicates and limits therapeutic options. It is one of the leading nosocomial bacterial pathogens, and the present study aims to determine the prevalence of ESβL producing K. pneumoniae isolates with their antibiotic susceptibility pattern in urine samples of the pregnant women with UTI.
Using standard isolation and identification procedures a total of 41 isolates were obtained from 417 midstream urine samples of pregnant women with suspected UTI in Karnataka. The antibiotic resistance profile of each isolate was performed by Kirby-Bauer disc diffusion method and ESβL production by standard phenotypic method.
Isolation rate of K. pneumoniae in pregnant women was 19.9% and overall incidence rate was 9.8%. Among the 41 K. pneumoniae isolates, 26 (63.4%) were ESβL producers and all were found to be Multi Drug Resistance (MDR). The antibiotic susceptibility test (AST) for the isolates revealed that the highest number of K. pneumoniae were resistant to ampicillin (75.6%) followed by, nitrofurontoin and cefuroxime (73.1%) and least to chloramphenicol (12.1%). ESβL producers were highly resistance to nitrofurontoin (69.2%) and cotrimonazole (65.2%) and lower resistance was (7.6%) to amaikacin, observed. A higher resistance pattern to these two antibiotics was observed against ESβL non producing K. pneumonia but lowest to polymyxin B (13.3%) instead of amikacin (26.6%). All the isolates were found to be susceptible to imipenem.
Present investigation revealed high prevalence of MDR- ESβL producing Klebsiella pneumoniae, which indicates dire need for effective ESβL surveillance in the community by using cost effective antimicrobials agents.
肺炎克雷伯菌给全球医护人员带来了新问题，使治疗选择变得复杂并受到限制。它是主要的医院内细菌病原体之一，本研究旨在确定尿路感染的孕妇尿液样本中产生超广谱β-内酰胺酶（ESβL）的肺炎克雷伯菌分离株的流行情况及其抗生素敏感性模式。
采用标准的分离和鉴定程序，从卡纳塔克邦疑似尿路感染的孕妇的417份中段尿样本中总共获得了41株分离株。通过 Kirby-Bauer 纸片扩散法检测每个分离株的抗生素耐药谱，并用标准表型方法检测ESβL的产生情况。
孕妇中肺炎克雷伯菌的分离率为19.9%，总体发病率为9.8%。在41株肺炎克雷伯菌分离株中，26株（63.4%）为ESβL产生菌，且均为多重耐药（MDR）菌。对分离株的抗生素敏感性试验（AST）显示，肺炎克雷伯菌对氨苄西林耐药的数量最多（75.6%），其次是呋喃妥因和头孢呋辛（73.1%），对氯霉素耐药的数量最少（12.1%）。ESβL产生菌对呋喃妥因（69.2%）和复方新诺明（65.2%）高度耐药，对阿米卡星的耐药性较低（7.6%）。观察到对这两种抗生素，非ESβL产生的肺炎克雷伯菌的耐药模式更高，但对多粘菌素B的耐药性最低（13.3%），而不是对阿米卡星（26.6%）。所有分离株对亚胺培南均敏感。
目前的调查显示，产超广谱β-内酰胺酶的多重耐药肺炎克雷伯菌的患病率很高，这表明迫切需要通过使用具有成本效益的抗菌药物在社区进行有效的超广谱β-内酰胺酶监测。
