Fecal carriage of extended-spectrum beta-lactamase-producing enterobacteriaceae in intensive care unit patients

The widespread use of antibiotics during the past few decades has led the bacteria to acquire resistance enzymes. The extended-spectrum beta-lactamases (ESBLs) hydrolyze extended-spectrum cephalosporins but are usually susceptible to inhibition by clavulanic acid and tazobactam. The genes for ESBL production are carried on plasmids, and this contributes to spread of these resistant genes in the bacterial population. The first reports of ESBLs were first in the mid-1980s and were mostly in Klebsiella pneumoniae and Escherichia coli. rriage of ESBL-producing commensal strains of Enterobacteriaceae is a threat as it can get transferred to the pathogenic strains. The first reports on fecal carriage of ESBL-producing Enterobacteriaceae were from Spain and Poland in 2001 and 2002, respectively. owledge of the fecal carriage of ESBL strains is essential for formulation of antibiotic policy. ESBL strains render the antibiotic therapy ineffective and contribute to the seriousness of hospital-acquired and community infections. fections with ESBL-producing organisms are associated with higher morbidity, longer hospitalization. Infections due to these organisms are hospital acquired with stay in the Intensive Care Units (ICUs), exposure to antibiotics, and in dwelling devices being the associated risk factors. The infections caused by ESBL producers are urinary tract infection, intra-abdominal infections such as peritonitis, cholangitis, and intra-abdominal abscess. is study focuses on screening for fecal carriage of ESBL-producing Enterobacteriaceae members using rectal Background and Aims: Increasing and indiscriminate use of antibiotics has led the bacteria to develop resistance to most of the antibiotics. Beta-lactamase production is the mechanism of resistance to beta-lactams. Extended-spectrum beta-lactamases (ESBLs) have been found in the members of Enterobacteriaceae such as Escherichia coli and Klebsiella spp. which are the common health-care-associated pathogens. The aim was to study the rate of fecal carriage of ESBL-producing Enterobacteriaceae in patients admitted to the Intensive Care Unit (ICU) of tertiary care hospital and follow them subsequently for the development of infections. Materials and Methods: A hospital-based descriptive study was conducted in the department of microbiology of a tertiary care hospital for a period of 2 months from June 2016 to August 2016. Rectal swabs were collected from the patients admitted to the ICU after a period of 48 h. The swab was inoculated onto a special selective media (ChromID ESBL media). The results were noted according to the color of the colony produced. These patients are followed for the development of infection and the ESBL-producing organisms. Results: A total of 60 rectal swabs were cultured, 39 (65%) showed a positive result. Out of which, 22 (56%) were ESBL-producing E. coli and 17 (43%) Klebsiella spp. Twenty-three (38%) of the total patients screened were infected with ESBL-producing organisms. Conclusion: The study revealed high rates of carriage of ESBL producers in patients admitted to the ICU.