Indian Journal of Pathology and Microbiology
Home About us Instructions Submission Subscribe Advertise Contact e-Alerts Ahead Of Print Login 
Users Online: 2024
Print this page  Email this page Bookmark this page Small font sizeDefault font sizeIncrease font size


 
  Table of Contents    
LETTER TO EDITOR  
Year : 2017  |  Volume : 60  |  Issue : 1  |  Page : 142-143
β-lactam susceptibility in extended-spectrum β-lactamase-producing isolates


1 Department of Microbiology, Government Medical College, Nagpur, Maharashtra, India
2 Department of Microbiology, RCSM Government Medical College, Kolhapur, Maharashtra, India

Click here for correspondence address and email

Date of Web Publication14-Feb-2017
 

How to cite this article:
Agrawal GN, Rahangdale HD, Walawalkar AW. β-lactam susceptibility in extended-spectrum β-lactamase-producing isolates. Indian J Pathol Microbiol 2017;60:142-3

How to cite this URL:
Agrawal GN, Rahangdale HD, Walawalkar AW. β-lactam susceptibility in extended-spectrum β-lactamase-producing isolates. Indian J Pathol Microbiol [serial online] 2017 [cited 2017 Mar 24];60:142-3. Available from: http://www.ijpmonline.org/text.asp?2017/60/1/142/200044


Editor,

We congratulate Dr. Trupti Bajpai et al. for sharing an interesting data of antibiotic resistance of extended-spectrum β-lactamase (ESBL) and non-ESBL Gram-negative bacterial isolates.[1] Although the work is carefully and critically done, some clarifications are needed.

Having carefully gone through the article, it has been observed that only 89.6% ESBL producers were resistant to piperacillin and their resistance to cefazolin, cefotaxime, ceftazidime, cefepime, and aztreonam varied from 89% to 94%, i.e., 10.4% ESBL producers were sensitive to piperacillin and their sensitivity to cefazolin, cefotaxime, ceftazidime, cefepime, and aztreonam varied from 6% to 11%. The same fact was nicely depicted in the graph.[1] It is an established fact that ESBL-producing isolates should be considered resistant to all penicillins, cephalosporins, and aztreonam.[2]

Bajpai et al.[1] in their study compared drug resistance between ESBL and non-ESBL producers. They reported that resistance to many antibiotics such as nitrofurantoin, cefoxitin, piperacillin-tazobactam, imipenem, meropenem, levofloxacin, gentamicin, and amikacin was more in non-ESBL producers as compared to ESBL producers. Resistance to only few antibiotics such as co-trimoxazole, norfloxacin, tetracycline, and colistin was found to be more in ESBL producers as compared to non-ESBL producers. It is not proper to compare the resistance of β-lactam antibiotics in two groups. ESBLs are carried on a plasmid that often mediates resistance to other non β-lactam antimicrobial agents.[3] Hence, it is a common observation that resistance to the non β-lactam antimicrobial agents is more in ESBL producers as compared to non-ESBL producers.

Through this letter, we would like to emphasize strict adherence to CLSI guidelines that serves as the standard for the uniformity and is based on sound technical background. This will also avoid misleading the clinician for the choice of the drug for effective patient management.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
   References Top

1.
Bajpai T, Pandey M, Varma M, Bhatambare GS. Prevalence of extended spectrum beta-lactamase producing uropathogens and their antibiotic resistance profile in patients visiting a tertiary care hospital in central India: Implications on empiric therapy. Indian J Pathol Microbiol 2014;57:407-12.  Back to cited text no. 1
[PUBMED]  Medknow Journal  
2.
Russo TA, Johnson JR. Diseases caused by gram negative enteric bacilli. In Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J (eds.). Harrison's Principles of Internal Medicine, Vol. 1, 18th Ed, Mc Graw Hill, New Delhi, 2012, p1246-56.  Back to cited text no. 2
    
3.
Winn WC, Allen SD, Janda WM, Koneman EW, Procop GW, Schreckenberger PC, Woods GL. Antimicrobial susceptibility testing. In Koneman's Color Atlas and Textbook of Diagnostic Microbiology, 6th Ed, Lippincott Williams & Wilkins, Philadelphia, 2006, p 945-1021.  Back to cited text no. 3
    

Top
Correspondence Address:
Gopal Nandlal Agrawal
Department of Microbiology, Government Medical College, Nagpur, Maharashtra
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0377-4929.200044

Rights and Permissions




 

Top
 
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Email Alert *
    Add to My List *
* Registration required (free)  


    References

 Article Access Statistics
    Viewed176    
    Printed3    
    Emailed0    
    PDF Downloaded21    
    Comments [Add]    

Recommend this journal