Mohit Caubey and Shenoy Suchitra M* Pages 68 - 71 ( 4 )
Background: Extended spectrum beta lactamases (ESBL) are responsible for increased resistance to third generation cephalosporins. Proteus species is an important cause of both community acquired and nosocomial infections. The Proteus species is usually susceptible to beta lactam drugs but there is progressive increase in beta lactam resistance and recently, ESBLs are also fast spreading to this species.
Objective: This study was conducted to study ESBL production and occurrence of TEM, SHV and CTX-M beta lactamases in clinical isolates of Proteus species in a tertiary care center.
Method: This prospective hospital based study was carried out in Microbiology, Kasturba Medical College, Mangalore over 9 months. All non-duplicate consecutive Proteus isolates were identified and antibiotic susceptibility testing was done. ESBL detection was done by double disk synergy method and TEM, SHV, CTX-M genes were detected by PCR.
Results: 84 Proteus isolates from urine (29), blood (1), respiratory secretions (2), tissue (20) and exudates (47) were included in the study. 20.2% (17) were ESBL positive by disk synergy method. CTX-M was present in 6, TEM in 2 and both in 9 isolates. SHV was not present in any isolate.
Conclusion: Our findings showed that 20% of clinical isolates of Proteus species were ESBL producers. 52% of ESBL positive isolates carried both TEM and CTX-M genes followed by CTX-M alone (35%) and only 11% had TEM alone. This stresses on the fact that ESBL detection should be done routinely in Proteus isolates and the genotype surveyed periodically for better management.
ESBL, TEM, SHV, CTX-M, Proteus, enterobacteriaceae.
Bokaro General Hospital, Bokaro Steel City, Jharkhand 827004, Kasturba Medical College, Manipal University, Mangalore, Karnataka