PREVALENCE, ANTIBIOTIC SUSCEPTIBILITY PATTERNS, AND CLINICAL CORRELATES OF ESBL-PRODUCING ENTEROBACTERIACEAE AMONG ICU PATIENTS IN A TERTIARY CARE HOSPITAL.

Abstract

Extended-Spectrum Beta-Lactamase (ESBL)-producing Enterobacteriaceae are a major cause of multidrug-resistant infections in Intensive Care Units (ICUs), posing significant treatment challenges. This study aimed to determine the prevalence, antibiotic susceptibility patterns, and clinical correlates of ESBL-producing Enterobacteriaceae among ICU patients in a tertiary care hospital.

Methods: A cross-sectional observational study was conducted from January to December 2024 in the Department of Microbiology in collaboration with the Department of General Medicine at Mahamaya Rajkiya Allopathic Medical College, Ambedkar Nagar, collaboration with Sarojini Naidu Medical College, Agra. ICU patients aged 18–75 years with culture-positive Enterobacteriaceae isolates and an ICU stay ≥48 hours were included. Clinical specimens were processed for culture, identification, and antibiotic susceptibility testing according to standard protocols.

Results: Among 129 ICU patients, 101 clinical specimens yielded 100 isolates, of which 42 (41.6%) were ESBL-positive. Escherichia coli (28%) and Klebsiella spp. (18%) were the most common ESBL-producing organisms. Urine and endotracheal tube samples showed the highest ESBL positivity. Most isolates exhibited high resistance to β-lactams and fluoroquinolones, whereas carbapenems, nitrofurantoin, and aminoglycosides retained good activity.

Conclusion: ESBL-producing Enterobacteriaceae are prevalent in ICU patients and exhibit multidrug resistance, limiting therapeutic options. Carbapenems and select non-β-lactams remain effective, highlighting the need for robust antimicrobial stewardship, strict infection control, and regular surveillance in ICUs to curb the spread of resistant organisms.