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Int. J. Environ. Res. Public Health 2018, 15(1), 155; https://doi.org/10.3390/ijerph15010155

Trends in Resistance to Extended-Spectrum Cephalosporins and Carbapenems among Escherichia coli and Klebsiella spp. Isolates in a District in Western India during 2004–2014

1
Department of Public Health Sciences, Karolinska Institutet, 17177 Stockholm, Sweden
2
Bac-Test Laboratory, College Road, Nashik 422005, Maharashtra, India
3
Indian Initiative for Management of Antibiotic Resistance, Department of Environmental Medicine, R.D. Gardi Medical College, Ujjain 456006, India
These authors contributed equally to this work.
*
Author to whom correspondence should be addressed.
Received: 9 December 2017 / Revised: 11 January 2018 / Accepted: 16 January 2018 / Published: 19 January 2018
(This article belongs to the Special Issue Antimicrobials and Antimicrobial Resistance in the Environment)
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Abstract

Surveillance data on the level of resistant bacteria is needed to inform strategies to reduce the development and spread of antibiotic resistance. The aim of this study was to determine the non-susceptibility trends to extended-spectrum cephalosporins and carbapenems among Escherichia coli and Klebsiella spp. isolates from the district of Nashik in Western India during the period 2004–2014. Antibacterial susceptibility testing of clinical isolates was performed using Kirby-Bauer disc diffusion method to determine inhibitory zone diameters. The change in proportions of non-susceptible bacteria over calendar time was investigated with spline transformations in a logistic regression model. For the extended-spectrum cephalosporins, the proportions of non-susceptible E. coli and Klebsiella spp. isolates were above 78.4% and 84.9% throughout the study period, respectively. E. coli and Klebsiella spp. isolates exhibited carbapenem non-susceptibility levels as high as 76.9% and 84.1% respectively. The proportions of extended-spectrum betalactamase (ESBL)-producing isolates ranged from 38.3–85.9% in E. coli and from 45.1–93.1% in Klebsiella spp. Significantly higher proportions of non-susceptible and ESBL-producing isolates were found among isolates from inpatients compared to isolates from outpatients for both E. coli and Klebsiella spp. (p < 0.050). The high proportions of non-susceptible isolates observed show that there is great need to focus on optimal use of antibiotics to reduce the development of antibiotic resistance. View Full-Text
Keywords: Escherichia coli; Klebsiella; India; ESBL; cephalosporins; carbapenems; antibiotic resistance; non-susceptible; antimicrobial susceptibility testing Escherichia coli; Klebsiella; India; ESBL; cephalosporins; carbapenems; antibiotic resistance; non-susceptible; antimicrobial susceptibility testing
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Odsbu, I.; Khedkar, S.; Lind, F.; Khedkar, U.; Nerkar, S.S.; Orsini, N.; Tamhankar, A.J.; Stålsby Lundborg, C. Trends in Resistance to Extended-Spectrum Cephalosporins and Carbapenems among Escherichia coli and Klebsiella spp. Isolates in a District in Western India during 2004–2014. Int. J. Environ. Res. Public Health 2018, 15, 155.

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