Extended spectrum beta lactamase (ESBL) producing Escherichia coli and Klebsiella pneumoniae are known to cause nosocomial outbreaks which emerged as one of the world’s extreme health threats in past two decades. In this context, the present study was aimed to isolate multi drug resistant E. coli and K. pneumoniae and evaluated the ESBL production. The samples were collected from district Govt. hospital, Ariyalur, Tamil Nadu, India in the period of September 2014 to September 2015 and a total of 1400 nosocomial isolates were isolated. All the isolates were subjected to antibiotic susceptibility testing by Kirby–Bauer disc diffusion method. E. coli (n = 160) had shown high antibiotic resistance pattern to Amikacin, Ceftazidime and Nalidixic acid while K. pneumoniae (n = 110) had shown high antibiotic resistance pattern to Ceftazidime and Nalidixic acid. Based on the phenotypic confirmatory test, 163 (60.4%) isolates (n = 89, E. coli and n = 74, K. pneumoniae) were ESBL producer. ESBL-positive isolates were screened for the presence of ESBL encoding bla_TEM, bla_SHV, bla_CTX-M-1, bla_NDM-1, bla_IMP1 and bla_GES resistance genes by multiplex polymerase chain reaction (mPCR). Among the ESBL producing genes, bla_CTX-M-1 was the highest (90.8%) prevalence followed by bla_TEM (77.3%), bla_GES (19%) and bla_NDM-1 (3.1%) alone or together. The present study concluded that the highest prevalence of ESBL producing MDR E. coli and K. pneumoniae with multiple resistance genes demand for new therapeutic options.

中文翻译：

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印度三级医院的产超广谱β-内酰胺酶的大肠杆菌和肺炎克雷伯菌的遗传测定和表征

众所周知，产生大范围β-内酰胺酶（ESBL）的大肠杆菌和肺炎克雷伯菌会引起医院内暴发，在过去的二十年中，这种暴发已成为世界范围内的极端健康威胁之一。在这种情况下，本研究旨在分离具有多重耐药性的大肠杆菌和肺炎克雷伯菌，并评估ESBL的产生。样品是从地区政府收集的。2014年9月至2015年9月，印度泰米尔纳德邦Ariyalur医院，共分离出1400株医院分离株。通过Kirby-Bauer纸片扩散法对所有分离株进行抗生素敏感性测试。大肠杆菌（n = 160）对阿米卡星，头孢他啶和萘啶酸表现出高耐药性，而肺炎克雷伯菌（n = 110）对头孢他啶和萘啶酸表现出高耐药性。根据表型确证试验，ESBL产生者为163（60.4％）分离株（n = 89，大肠杆菌，n = 74，肺炎克雷伯菌）。筛选ESBL阳性分离株是否存在ESBL编码的bla _TEM，bla _SHV，bla _{CTX - M-1}，bla _NDM-1，bla _IMP1和bla _GES通过多重聚合酶链反应（mPCR）获得抗性基因。在产生ESBL的基因中，bla _CTX-M-1的患病率最高（90.8％），其次是bla _TEM（77.3％），bla _GES（19％）和bla _NDM-1（3.1％）。本研究的结论是，具有多重耐药基因的产ESDR的MDR大肠杆菌和肺炎克雷伯菌的流行率最高，需要新的治疗选择。