PREVALENCE OF EXTENDED SPECTRUM BETALACTAMASES PRODUCING ENTEROBACTERIACEAE IN CHILDREN LESS THAN 18 YEARS

Objectives-This study sought to determine the proportion of E.coli and K.pneumoniaeisolates from children that are ESBL producers. It also assessed the spectrum of such infections aswell as the antibiotic sensitivity pattern of the isolates in a tertiary care hospital. Methods -This partly retrospective study was done from January 2008 to June 2011 (January 2008 to December 2009were retrospective and January 2010 to June 2011 were prospective) and the subjects were childrenbelow 18 years of age. Relevant clinical data was collected from case records of patients. All isolateswere identified and confirmed by standard conventional methods in the microbiology department ofthe hospital. NCCLS guidelines were used to define ESBL producers which our microbiology lab hasbeen routinely doing since 2007. The isolates were tested for sensitivity against different antibioticsby KirbyBauer disk diffusion method.Results - 437 out of 784 (56) of E.coli isolates were ESBLproducers while 132 out of 246 (56) of K.pneumoniae were ESBL producers.Approximately 50 of allInfections with ESBL producers were seen in infants. 82 (360 of 437) of ESBL produing E coli werecultured from urine. Of the 256 patients in whom complete information was available 149 (58) hadreceived one or more antibiotics prior to collection of culture specimens. All ESBL isolates weresensitive to Imipenem and meropenem. 95 of ESBL E.coli isolates were sensitive to Amikacin while itwas 86 for Nitrofurantoin. Among ESBL producing K.pneumoniae only 68 were sensitive toAmikacin.Conclusion- There is high prevalence of ESBL producing K.pneumoniae and E.coli in atertiary care hospital setting. Antibiotic options are expensive and require the parenteral route.