Antimicrobial Susceptibility Testing and Esbl Detection from the Bacteria in Haemodialysis Patients

Abstract

Objective of Study: To find out the antimicrobial sensitivity and extended spectrum -lactamase producing 
organisms among clinical isolates recovered from patients on haemodialysis. Extended spectrum -lactamase are 
enzymes produced from some strains of gram negative bacilli that mediate resistance to extended spectrum 
cephalosporin and aztreonam. They are most common in E.coli and Klebsiella species but are present in variety of 
enterobacteriacea. 
Design of Study: Experimental and observational study.  
Place and duration of Study: This study was carried out in Microbiology Department of BMSI, JPMC, Karachi. 
This study was carried out from June 2005 to June 2006.  
Materials and Methods: A total of 250 cases irrespective of age and gender were included in this study. A total of 
15 gram positive cocci (7.5%) and 175 (87.5%) gram negative organisms were recovered. In this study 66.66% 
E.coli and 33.33% Klebsiella species were ESBL producing. Antimicrobial sensitivity pattern in this study show that 
most of the organisms were sensitive to 2nd and 3rd generation cephalosporins and fluroquinolones i.e. ciprofloxacin. 
Results: Table 1 shows isolation of ESBL producing organisms from 200 positive cases. Out of these 175 cases 
were from Enterobacteriaceae, among these 06 (3.42%) cases have been found to be ESBL producing organisms. 
Conclusion: The results of this study support the use of initial antimicrobial therapy to reduce the spread of 
infection and other complications. Currently ciprofloxacin is regarded as the drug of choice for the treatment of 
infection caused by both gram negative and gram positive bacteria in patients on hemodialysis