In vitro Activity of Tigecycline against Clinical Isolates of Extended Specrtum Beta Lactamase Producing Enterobacteriaceae in Tertiary Care Hospital

Introduction In India, the extended-spectrum -lactamase (ESBL) producing strains of Enterobacteriaceae have emerged as a challenge in the hospitalized as well as the community based patients. Among wide array of antibiotics, -lactam is most widely used agent of all antibiotics in use. However new -lactamases emerged against each of the new class of -lactams that were introduced and caused resistance. So the present study was conducted with an objective to find out the presence of ESBLs among the Enterobacteriaceae isolates and to determine tigecycline activity against it. Aim To isolate and detect the extended-spectrum -lactamase (ESBL) producing Enterobacteriaceae and to determine in vitro activity of tigecycline among them. Material and methods Various specimens received to the laboratory within two hours of collection were processed according to the standard microbiological technique. Results Out of 606 Enterobacteriaceae, 287 isolates were ESBL producers. Urine and pus specimen yielded the highest percentage of ESBL isolates i. e.55.41 % and 47.17 % respectively. Majority of ESBL isolates ware seen in age group of above 60 years (61.61 %) and we observed male preponderance. Among IPD patients majority of ESBL producers were from ICU followed by Orthopaedic ward i. e.81.44 % and 59.18 % respectively. Klebsiella species (74.48 %) was most common ESBL producer.93.73 % of the ESBL producers were susceptible and 2.78 % isolates were resistant to tigecycline by E Test while 90.6 % were susceptible and 4.18 % were observed to be resistant by disc diffusion method. Conclusion Tigecycline can play a key role as therapeutic option in tackling ESBL producing Enterobacteriaceae. However, clinicians need to prescribe tigecycline appropriately, in order to avoid the emergence of resistant strains. From susceptibility testing by E test and disc diffusion, as there was no significant difference for tigecycline susceptibility.