title: Therapeutic challenges of ESBLS and AmpC beta-lactamase producers in a tertiary care center.
abstract: BACKGROUND
  Resistance to broad-spectrum beta lactams mediated by extended spectrum beta lactamases (ESBLs) and AmpC beta lactamases (AmpC βLs) enzymes is an increasing problem worldwide. Determination of their prevalence is essential to formulate an effective antibiotic policy and hospital infection control measures. Present study was undertaken to determine the prevalence of ESBL and AmpC βL producers in ICU of a tertiary care center.
  
  
  METHODS
  A total of 262 clinical isolates comprising of Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis that were recovered from various clinical specimens over a one year period, were studied. Antibiogram profile was determined to conventionally used antibiotics, along with recommended tests for detection of ESBL and AmpC βL production.
  
  
  RESULTS
  40.07% (105/262) were found to be ESBL producers, 14.8% (39/262) were AmpC bL producers. The coexistence of ESBL and AmpC βL producers was detected in 9.9% (26/262) of the isolates.
  
  
  CONCLUSIONS
  Screening of multidrug resistant bacteria especially belonging to the Enterobacteriaceae poses considerable therapeutic challenges in critical care patients because of the production of ESBL and AmpC βL. Strategies to keep a check on the emergence of such drug resistant microbes by hospital environmental surveillance and laboratory monitoring should form an important aspect of Hospital Infection control policy guidelines.
authors.affiliation: Associate Professor, Dept of Microbiology, AFMC, Pune 411040, India.
authors.forename: Naveen
authors.initials: N
authors.lastname: Grover
authors.affiliation: Prof & HOD, Dept of Microbiology, AFMC, Pune 411040, India.
authors.forename: A K
authors.initials: AK
authors.lastname: Sahni
authors.affiliation: Lab Director, Fortis Hospital Labs NCR, India.
authors.forename: S
authors.initials: S
authors.lastname: Bhattacharya
keywords: AmpC beta lactamase; Escherichia coli; Extended spectrum beta lactamase; Klebsiella pneumoniae