Journal of AdvancedMedical and Dental Sciences Research

Aim: To determine the prevalence Of ESBL(Extended Spectrum Beta Lactamases) Producing Gram Negative Bacilli Isolated From Post-Operative Wound Infection. Material and methods: Patients with infected wound and infected burn patients were included in this study. A sterile technique was applied to aspirate or collect pus or wound swab from abscess or wound infection, either by disposable syringe or by sterile swab stick and inoculated in Blood agar and MacConkey agar media. After overnight incubation at 37°C, plates were checked for presence of any suspected pathogens. Identification of organisms were done as per standard laboratory methods of identification and antimicrobial sensitivity of the isolates were tested against different antibiotics. The method recommended by Clinical Laboratories Standard Institute (CLSI) requires a two step approach of initially screening for ESBL production and then performing confirmatory tests on screen positive isolates. Results: Among the 94 bacterial isolates 75 (79.8%) were gram negative and 19 (20.2%) were Gram-positive. Out of gram-negative species, majority were Klebsiella species 18(24.0%) followed by E. Coli 18(24.0%) and Pseudomonas species 16(21.3%) . Total 75 isolated gram-negative bacteria were screened for suspected ESBLs producers on the basis of MIC ESBL breakpoints by agar dilution method, out of which 71 (94.7%) were found suspected ESBLs producers and rest 4 (5.3%) gave negative result. Screening positive 71 suspected ESBLs producing bacteria were subjected to phenotypic confirmatory test, 48 (67.6%) were found as confirmed ESBL producers & 23 (32.4%) showed negative result. Out of 75 gram-negative bacteria 48 (67.6%) were found to ESBLs producer. Higher rate of ESBLs was observed in Klebsiella species 18 (81.8%) out of 22, followed by E. Coli 16 (76.2%) out of 21, Pseudomonas species 10 (52.6%) out of 19& Proteus species4 (30.8%) out of 13. Conclusion: Existing of extended spectrum β-lactameses in bacteria and their potential multidrug resistance will create serious problem in the future as their continuous mutation and limited therapeutic option. Indiscriminate use of antibiotics especially 3rd generation cephalosporins and monobactams should be avoided.