BACKGROUND: Enrerobacteriaceae species are the major leading cause of bloodstream infections in
many developing countries. Moreover, ESBL and Carbapenemase-producing Enterobacteriaceae
species are often associated with high resistance to a wide class of antibiotics. There are few studies regarding the
bloodstream infections causing by Enterobacteriaceae with the production of Extended-spectrum β-lactamases and
Carbapenemase enzymes in Tripura, North-East India. This study aimed to determine the “ proportion of ESBL and
carbapenemase-producing Enterobacteriaceae causing bloodstream infection and showing Multi-drug resistance (MDR) in
infected patients'' in Tertiary care Hospital at Agartala, Tripura.
METHOD: Blood samples were collected from all indoor and outdoor patients suspected of Bloodstream infection. Then
specimens were inoculated in various culture media after that with this culture isolates we performed gram staining and many
biochemical tests (as per CLSI guidelines) to identies the Enterobacteriaceae species. And the production of β-lactamases
and Carbapenemase was conrmed by the combined disk test and Modied Hodge method.
RESULTS: In this study out of 760 samples processed in the laboratory 77 (10.13%) was tested positive for bacteremia from
which 42 (54.54%) blood specimens were infected by Enterobacteriaceae. The members of the Enterobacteriaceae family
isolated in patient samples are E.coli (22/42, 52.38%), K. pneumoniae (11/42, 52.38%) others are Enterobacter spp. (8/42,
52.38%) and S.typhi(1/42, 2.38%).
In all 42 Enterobacteriaceae species, 17 (40.47%) isolates were found ESBL positive on antibiotic screening which is conrmed
by Combined disc diffusion test, and out of 17 Beta-lactamase producers 8 (47.05%) were E. coli, 5 (29.41%) were K. pneumoniae
and 4 (23.52%) were Enterobacter spp.
And among 42 isolates of Enterobacteriaceae 16 (38.09%) isolates showed Carbapenemase producers, in that 8 (50%) were
E.coli, 5 (31.25%) were K. pneumoniae, and 3 (18.75%) were Enterobacter spp.
CONCLUSION: This study aims to provide an early, rapid, and effective phenotypic method for identifying Multi-drug resistant
(MDR) Bloodstream infections (BSIs) causing by the species of the Enterobacteriaceae family
Evaluation of Candida bloodstream infection and antifungal utilization in a tertiary care hospital
