Invitro sensitivity pattern of ESBL Amp-C producing Enterobacteriaceae members to newer antimicrobials

INTRODUCTION In the last two decades, drug resistance has emerged as a serious threat for clinicians in the treatment of the Enterobacteriaceae infections. Extended Spectrum Beta Lactamase producing Enterobacteriaceae are resistant to almost all generations of Cephalosporins except the fifth generation drugs. Carbapenems are the drug of choice for betalactamase producing (Extended Spectrum Beta Lactamase and Amp C) Enterobacteriaceae isolates. Aim of the present study is to identify the effectiveness of newer antimicrobials against Extended Spectrum Beta Lactamase Producers. MATERIALS AND METHODS Total of 100 samples obtained from both in-patients and out-patients of PSG Hospitals were studied. RESULTS For all the ESBLs AmpC producing organisms tested in this study Doripenem has the highest sensitivity(93) followed by Tigecycline (90 ), Piperacillin-tazobactum(78), Cefepimetazobactum (68) and Cefaperazone-sulbactum(61). DISCUSSION In the mid-1980s, when ESBLs were discovered, the treatment of Extended Spectrum Beta Lactamase producers became difficult, which was overcome by use of betalactam and betalactam inhibitor combinations. Inappropriate therapeutic management of ESBLs is a well recognized risk factor for development of ESBLs resulting in significant morbidity and mortality. CONCLUSION Extended Spectrum Beta Lactamase producing Enterobacteriaceae warrants appropriate use of antibacterial agents. Increase in emergence of carbapenamase producing Enterobactericeae in recent times, necessitates the need for beta lactam and beta lactamase inhibitor combinations as an option for the treatment of infections due to ESBL-producing organisms.