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Updated: Oct 13, 2025

Antimicrobial Synergy Testing by the Inkjet Printer-assisted Automated Checkerboard Array and the Manual Time-kill Method
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Piperacillin/tazobactum and cefotaxime decrease the effect of beta lactamase production in multi-drug resistant K.

Chackaravarthi Gnanasekaran1, Ahmed S Alobaidi2, Ramachandran Govindan1

  • 1Department of Marine Science, Bharathidasan University, Tiruchirappalli 620024, Tamil Nadu, India.

Journal of Infection and Public Health
|November 13, 2021
PubMed
Abstract

Insights

Multi-drug resistant Klebsiella pneumoniae strains producing extended spectrum beta-lactamase (ESBL) were identified. Antimicrobial susceptibility testing confirmed resistance, highlighting the need for effective treatment strategies against these critical pathogens.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Antimicrobial Resistance

Background:

  • Multi-drug resistant Klebsiella pneumoniae poses a significant global health threat, particularly in developing nations.
  • Recognized by the WHO as a critical pathogen, its increasing prevalence necessitates urgent investigation.
  • This study focuses on identifying extended spectrum beta-lactamase (ESBL) producing strains and assessing their antimicrobial susceptibility.

Purpose of the Study:

  • To detect and characterize extended spectrum beta-lactamase (ESBL) producing Klebsiella pneumoniae strains.
  • To evaluate the antimicrobial susceptibility patterns of these resistant K. pneumoniae isolates.
  • To provide data for informed treatment strategies against ESBL-producing K. pneumoniae.

Main Methods:

  • Disc diffusion method was employed to identify multi-drug resistance according to CLSI guidelines.
  • Primary ESBL detection involved ceftazidime and cefotaxime, with confirmation via double disc synergy and phenotypic tests using clavulanic acid combinations.
  • Minimum inhibitory concentrations (MICs) of sensitive antibiotics against selected strains were determined using micro broth dilution.

Main Results:

  • The study identified multi-drug resistant Klebsiella pneumoniae strains with significant resistance characteristics.
  • Primary ESBL detection showed inhibition zones ≤22 mm (ceftazidime) and ≤27 mm (cefotaxime).
  • Phenotypic confirmation tests, including disc synergy, clearly indicated ESBL production in the selected K. pneumoniae isolates.

Conclusions:

  • The characterized Klebsiella pneumoniae strains exhibited pronounced multi-drug resistance.
  • Most tested antibiotics showed sensitivity, though piperacillin demonstrated resistance and effective enzyme cleavage.
  • All ESBL detection methods consistently confirmed the selected K. pneumoniae strains as ESBL producers.
Keywords:
Antibiotic resistanceCLSI guidelinesGene identificationGram negative bacteriaPhenotypic assayUrinary tract infection

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