ACTIVE SURVEILLANCE IS NEEDED FOR AMP-C β-LACTAMASE AND ESBL-PRODUCING ORGANISMS IN CHILDREN
ESPID Education. KHARE M. Jun 7, 2011; 7678 Disclosure(s): none to disclose
Dr. MILIND KHARE
Dr. MILIND KHARE

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Abstract
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ACTIVE SURVEILLANCE IS NEEDED FOR AMP-C β-LACTAMASE AND ESBL-PRODUCING ORGANISMS IN CHILDREN

Background and aims:
The emergence of multi-resistant Amp-C & ESBL-producing gram-negative bacteria in the community is one of the most significant recent epidemiologic changes in infectious diseases. In the years 2007-8 laboratory had vitek1 machine which could identify extended-spectrum β-lactamases (ESBLs) from isolates which were cefpodoxime (used as a marker) resistant. In an audit done from January 2007 to June 2008, 17 ESBLs were isolated from children. A method which can identify Amp-C β-lactamase and ESBL producing bacteria was adopted and evaluated for active surveillance.

Methods
Laboratory in the hospital adopted the five disc diffusion method on a single plate in the last quarter of 2008. Evaluation was done over a period of from 1st July 2009 to 31st December 2010.Type of specimen, location where specimen was collected; age of the patient was recorded

Results
72 children were identified with Amp C producers and 33 with ESBLs aged 2days to 16 years. 53(74%) Amp-C isolates & 31(94%) ESBLs were obtained from urine, while the others from a cough swab, pus, eye, ears and umbilicus (no bacteraemia). 57(79%) Amp-C isolates & 29(88%) ESBLs were obtained from the community specimens.

Conclusions
Thus Amp-C & ESBL-producing organisms are reported with increasing incidence in the children and the number increased manifold with active surveillance which was sought as they are potentially serious pathogens. It is important to look for these multi-resistant infections so as maintain high standard of quality of children care and best management of children’s illness episodes in the hospitals & community.

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