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Prospective Study for Antimicrobial Susceptibility of Escherichia coli Isolated from Various Clinical Specimens in India

Manu Chaudhary and Anurag Payasi

The aim of the present work was to study the prevalence of Extended-spectrum β-lactamases (ESBLs) and Metallo-β-lactamases (MβLs) among 464 E. coli clinical isolates obtained from various clinical specimens; and to study the susceptibility of various drugs against E. coli isolates. Phenotypic characterization and susceptibility studies were performed according to the methods described in Clinical and Laboratory Standards Institute guidelines (CLSI, 2010). The prevalence of ESBLs and MβLs was analyzed with Polymerase Chain Reaction (PCR), using the previously reported primers.
                               

                                    Among the four hundred sixty four isolates, 186 (40.08%) isolates were ESBLs positive, 75 (16.16%) isolates were MβLs positive, and 80 (17.24%) were both ESBLs and MβLs positive. The remaining 123 (26.50%) were non ESBLs and MβLs. TEM-types ESBLs (blaTEM-1, blaTEM-2, and blaTEM-50) were found in approximately 57% isolates. The prevalence of SHV-types, CTX-M-types and OXA-type was 29.03, 11.82 and 2.15%, respectively. Among the MβLs, the frequency of distribution of NDM-1, IMP-1, VIM-1 and KPC-types was 37.39, 21.33, 18.66, and 22.66%, respectively. In general, 92.6% E. coli isolates were susceptible to ceftriaxone plus EDTA plus sulbactam (CSE1034),
followed by meropenem (74.4%), imipenem (71.2%), piperacillin plus tazobactam (52.1%),  cefoperazone plus sulbactam (46.0%) and amoxycillin plus clavulanic acid (23.6%). Similarly, amoxycillin plus clavulanic acid showed the highest percentage of resistance (72.8%), followed by cefoperazone plus sulbactam (43.6%), piperacillin plus tazobactam (39.3%), imipenem (23.3%), meropenem (20.3%) and ceftriaxone plus EDTA plus sulbactam (CSE1034) (2.5%). Results of the present study revealed that most of the clinical isolates were susceptible to ceftriaxone plus EDTA plus sulbactam (CSE1034), and can be a potent antibacterial agent for the treatment of severe bacterial infections caused by E. coli.