Phenotypic cofirmatory disc diffusion test (PCDDT), double disc synergy test (DDST), E-test OS diagnostic tool for detection of extended spectrum beta lactamase (ESΒL) producing Uropathogens
- Journal of Applied Biotechnology & Bioengineering
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Rashid Iqbal,1 Nadeem Ikram,2 Muhammad Shoaib,1,2 Muhammad Javaid Asad,1 Raja Tahir Mehmood,1 Abida Niazi,3 Anam Asghar,4 Bushra Ishfaq,4 Faiza Naseer4
Government College University Faisalabad, Pakistan - Rashid Iqbal, Department of Biochemistry, Arid Agriculture University, Pakistan
- Nadeem Ikram, Department of Medical Technology, Shifa Tameer e Millat University Islamabad, Pakistan
- Muhammad Shoaib, Department of Biochemistry, Arid Agriculture University, Pakistan
- Muhammad Javaid asad, Department of Biochemistry, Arid Agriculture University, Pakistan
- Raja Tahir Mehmood, Department of Biochemistry, Arid Agriculture University, Pakistan
- Abida Niazi, University of Veterinary and Animal Sciences Lahore, Pakistan
- Anam Asghar, Government College University Faisalabad, Pakistan
- Bushra Ishfaq, Government College University Faisalabad, Pakistan
Abstract
Background: The aim of this study was to probe the best diagnostic tool for the detection of Extended Spectrum β-lactamase (ESβL) producing uropathogen and their antimicrobial susceptibility profile to treat the infections properly.
Methods: Clinical samples of urine were cultured on Cysteine Lactose Electrolyte Deficient (CLED) Agar medium. Antimicrobial sensitivity tests were carried out by Kirby-Bauer disc diffusion method. Phenotypic methods were used for further confirmation of β- lactamase production by phenotypic confirmatory disc diffusion test (PCDDT), double disc synergy test (DDST) and by E-test for ESBL production.Aswab on Mueller-Hinton (MH) agar plates was used for further studies and the Optical Density (O.D.) of the cultures was set to 0.1 (at 530 nm).
Results: Sample size N= 200 was selected from patients suffering from UTI. Out of the 200 samples, n=141 samples yielded Aerobic Gram Negative Bacteria (AGNB). The commonest organism isolated was E.coli n=108, best antimicrobial result of 95% was shown by imipenem. Among the AGNB isolates, 20 organisms (12.98%) were ESBL producers. E.coli showed highest ESBL production of 85%. The most effective antimicrobial in ESBL producers was Imipenem (84%) Augmentin was least sensitive (05%).
Conclusion:ESBL production is a common phenomenon in UTI patients and screening by DDST for these enzymes is a good epidemiological tool to assess the overall situation in a certain setup.It was also seen that Imipenem (Carbapenem) is the drug of choice.
Keywords
ESBL, CLED, DDST, AGNB isolates, imipenem, nosocomial infections, antibiotics, empirical, beta lactamases, cephalosporin, ulbactum, inhibitor, resistant , inoculation, mueller-hinton, multi-ezy strips, susceptibility
