Klebsiella is well known to the clinicians as a cause of community acquired bacterial pneumonia which has a high fatality rate if untreated. Klebsiella is among the five gram negative pathogens most commonly encountered in hospital acquired infections. As opportunistic pathogens, Klebsiella species primarily attack immunocompromised individuals. Reports from India show the occurrence of ESBL producers in Klebsiella species to range from 6.6 to 53% but the exact magnitude of the problem is not known. ICUs are often the epicentre of ESBL production in hospitals. Patients with ESBL producing organisms are often seriously ill patients with prolong hospital stays and in whom invasive medical devices are present for a prolonged duration. Heavy antibiotic use is also a risk factor since ESBL production frequently is accompanied by multiresistance to antibiotics, therapeutic options become limited. So far, however, ESBL producing Klebsiella strains have been susceptible to carbapenems and are the drugs of choice in the treatment. In this respect, emergence of imipenem –resistant ESBL producing Klebsiella strains will have a serious impact on remaining therapeutic options. To date, two diagnostic tests have been most commonly used to detect such isolates- double disc synergy test and Etest strip.

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