Publication

Abstract : ESBL producing GNB causing blood stream infections (BSI), skin and soft tissue (SSTI) and respiratory tract infection (RTI) are widely prevalent in Indian medical centers. We compared the in-vitro activity of five commonly used antimicrobials to treat such infections against the recently introduced carbapenem - ertapenem (ERT). Methods: From a collection of 776 clinically significant isolates prospectively collected (2005–2007) from seven medical centers, 238 GNB isolates (Escherichia coli [EC], = 122, Klebsiella spp. [KS], = 107 and Enterobacter spp. [ES] = 9) obtained from RTI (n = 75), BSI (n = 74), SSTI (n = 70) and urinary tract (n = 19) were tested. ESBL screen was performed by disc diffusion using cefotaxime (CTX) and ceftazidime (CZD), confirmed using CTX and CZD discs with and without clavulanic acid and Etest ESBL strips. Antimicrobial resistance to levofloxacin (LEV), amikacin (AMK), piperacillin/tazobactam (P/T), imipenem (IMP), meropenem (MER) and ERT was determined by agar dilution and Etest. Isolates were considered multi-drug resistant (MDR), if resistant to >2 classes. Polymerase Chain Reaction (PCR) was done to determine beta lactamases (bla)TEM, SHV and CTX-M among 120 isolates.