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Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
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Drug interactions occur when the pharmacological effect of one drug is altered by another substance, either enhancing or diminishing its activity. The drug whose activity is altered is known as the object drug, and the substance causing the alteration is called the agent drug or the precipitant. The net effects of these interactions are mostly undesirable, leading to decreased effectiveness or increased adverse effects. In rare cases, interactions can be beneficial, such as the enhanced...
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A urine culture and sensitivity test is a diagnostic procedure used to identify urinary tract bacterial infections and determine the most effective antibiotics for treatment. This test is generally preferred when a patient shows manifestations of a urinary tract infection, such as frequent or painful urination, cloudy or foul-smelling urine, or lower abdominal pain.Purpose of the TestThe primary goals of a urine culture and sensitivity test are to:Determine the specific bacteria causing the...
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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
Summary

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.

Keywords:
Antibiotic resistanceCLSI guidelinesGene identificationGram negative bacteriaPhenotypic assayUrinary tract infection

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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.