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Determination of resistance mechanisms and the genes coding for such resistance in clinically significant Enterobacteriacae isolated from urine at a state tertiary care referral hospital and a private hospital in Sri Lanka

NRC Grant: 14-045

Dr. E. Corea
Dept. of Microbiology
Faculty of Medicine
University of Colombo
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Area of Research: Medical Science
Status:Ongoing

 

objectives

a) To identify clinically significant enterobacteria isolated from urine to species level.

b) To determine, extended spectrum β-lactamase, Amp C β-lactamase and carbapenemase production in these isolates.

c) To identify the genes that encode for extended spectrum β-lactamase, Amp C β-lactamase and carbapenemase in these isolates.

d) To calculate the prevalence of resistance due to the above mentioned enzyme production in Enterobaceteriaceae in community acquired and hospital acquired urinary tract infections

overview

Resistance in Gram-negative bacteria, including enterobacteriaceae, has been increasing over the last decade. This is mainly due to the spread of strains producing extended-spectrum β- lactamases (ESBLs), AmpC β-lactamases and carbapenemases. Resistance is becoming more widespread globally including in Asian countries. Resistant strains of Enterobacteriaceae are common causes of infections, both in community acquired and nosocomial infections. The choice of effective agents to treat these infections is diminishing. The absence of new, effective antibiotics for Gram negative bacteria makes infection control the most important countermeasure against multidrug-resistant gram-negative pathogens. Formulation of local and national antibiotic guidelines and infection control guidelines requires a comprehensive study of the prevalence of resistant strains causing hospital and community acquired infections. In order to obtain this information it is important to establish standard and comprehensive testing of such resistant mechanisms. This study attempts to establish standard phenotypic and genotypic methods to detect ESBLs, Amp C beta lactamases and carbapenemases in enterobacteriaceae. By using these methods the prevalence of these resistant bacteria in community and hospital settings will be obtained for national and international data bases that will be useful to develop national antimicrobial policies and establish standard antimicrobial resistance surveillance. The study will evaluate the practicality of establishing these methods in the hospital setting in Sri Lanka, in state and private hospitals.