SUSCEPTIBILITY PATTERN OF AMP-C PRODUCINGGRAM NEGATIVE RODS
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Abstract
Objectives: To determine the frequency of Amp-C producing Gram negative rods and susceptibility pattern of isolates from various clinical specimens at a tertiary care setting.
Material and Methods: It was a Descriptive cross sectional study, conducted in the Department of Microbiology, Armed Forces Institute of Pathology, National University of Medical Sciences, Rawalpindi from February 2014 to February 2015. Gram negative rods isolated from various specimens were processed and identified according to standard procedures. The isolates were screened for production of Amp-C with cefoxitin disc (30?g) and antimicrobial sensitivity against first and second line antibiotics was tested by Kirby-Bauer disc diffusion method. The isolates resistant to cefoxitin were confirmed for Amp-C by cefotetan/cloxacillin E-strip method.
Results: Out of total 342 isolates of Gram negative rods, 135 were resistant to cefoxitin disc, and 120 were confirmed as Amp-C producers through cefotetan/cloxacillin E-strip method. Susceptibility pattern of 120 isolates yielding growth of Amp-C producing isolates was determined. The age of patients ranged from 2 to 93 years with male predominance. The most frequent isolation of Amp-C producing organisms was from urine 50 (42%) followed by pus and pus swab (33%) and blood (8%). Escherichia coli (42.5%) was the most common organism isolated followed by Klebseilla pneumoniae
(25%) and Enterobacter cloacae (15%). Sensitivity of isolates was highest to imipenem (82.5%) and lowest to cefoperazone-sulbactam (3.4%).
Conclusion: Frequency of Amp-C producing bacteria was high in our setup and carbapenems are being used to treat infections caused by multidrug resistant Gram negative rods. Sensitivity of the Amp-C producing isolates was higher to Carbapenems and Aminoglycosides.
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