Role of characterization of extended spectrum beta lactamase in infection management

Author(s): R. P. Singh, Nikunj Gupta, Purewal* S. S., Urvinder Pal Singh, Kulbir Singh, Sonu Panwar, Tarsem Lal, Kamesh Kumari, Harjinde Puri

Abstract

Antibiotic resistance is a major problem which the clinicians are facing these days while treating their patients. It is mainly due to beta lactamase production by most of the gram negative bacilli. Beta lactamases produced by gram negative bacilli hydrolyzes most of the cephalosporins and even carbapenums. Clinicians are therefore left with very limited choice. It is seen that antibiotic selection differs with different class of Extended Spectrum Beta Lactamase (ESBL). ESBL can be divided into four classes according to substrate profile and molecular sequencing of the genes. These are designated as A, B, C and D. ESBLs can be characterized by using ceftazidime, combination of ceftazidime plus clavulanic acid, cefoxitin, pipracillin and tazobactum and carbapenums. These help in the selection of appropriate antibiotic. By following this practice it is possible to some extent decrease the problem of treatment failure.

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