Vasumathi, A (2006) Study on Extended Spectrum Betalactamase (ESBL)producing Gram Negative Bacilli Isolated from Intensive Care Units. Masters thesis, Stanley Medical College, Chennai.
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Abstract
INTRODUCTION : Incidence of bacterial infection from Hospitals accounts for 5-10% in most developed nations while in India one in four patients Admitted into hospitals acquire bacterial infection59. Around 30% of Patients in Intensive Care Units were contracting infections during their Stay in hospital3, which leads to many complications in them. Since 1940, Penicillin- the first beta lactam antibiotic Remained the antibiotic of choice for many years. Bacteria were so Inventive that they developed many mechanisms to escape the action of Antibiotics and became resistant. Main mechanism was by the Production of β-lactamases. The first plasmid mediated β-lactamase Was TEM – 1 which was described in 1960s. Antibiotic resistance was High among organisms isolated from Intensive Care Units. Hence, the present study was undertaken to study the Extended Spectrum Beta Lactamase producing gram negative bacilli isolated from Intensive Care Units of Government Stanley Hospital, Chennai. AIM AND OBJECTIVES : To find the incidence of ESBL producing organisms in Intensive care units of Government Stanley Hospital. To prove association between prolonged stay in intensive care units and production of ESBL. To assess the outcome of treatment in patients with infections due to ESBL producing bacteria. To formulate treatment policy for those patients who are having severe infection resistant to treatment with routine antibiotics for avoiding further emergence of Extended Spectrum β- Lactamases CONCLUSION : Isolation of ESBL producing organisms from Intensive Care Units of Govt. Stanley Medical College Hospital was 38.95% by DDST and MIC which was high when compared to other studies from south India. Isolation of ESBL producing organisms were more in tracheobronchial aspirate of patients put on ventilator (44.44%) followed by urine (39.46%) and wound swab (38.46%). 1. In Intensive care units widespread use of third generation Cephalosporins has been cited as a contributing factor in the development of ESBL mediated resistance along with prolonged stay and intubations. So by following proper infection control and giving correct antibiotics after proper screening ESBL production can be minimised 2. DDST being simple and cheaper should be included in the microbiology laboratories as a routine test for early deduction of ESBL producing organisms in specimen from critically ill patients. 3. Though meropenem was 100% sensitive, ESBL producing organisms were also sensitive to cheaper drugs like, Co-trimoxazole (13.51%), Amikacin (48.65%) and Ciprofloxacin (16.22%). Hence if we screen carefully we can minimise the cost of treatment for the patients with infections due to ESBL producing organisms.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Extended Spectrum Betalactamase (ESBL) ; Gram Negative ; Bacilli ; Intensive Care Units. |
| Subjects: | MEDICAL > Microbiology |
| Depositing User: | Subramani R |
| Date Deposited: | 26 Jul 2017 06:18 |
| Last Modified: | 26 Jul 2017 06:18 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/1724 |
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