Detection of Carbapenem resistance among Escherichia coli and Klebsiella pneumoniae isolates in a tertiary care hospital in South India

Abstract

Introduction: Carbapenems are a class of ?lactam antibiotics with a broad spectrum of activity and greatest potency against Gram positive and Gram negative bacteria and their use has markedly increased in the past few decades. The development of carbapenem resistance has now become a grave concern in the treatment of diseases. Materials and Methods: The study was a laboratory based cross sectional study done with the main aim to detect the presence of carbapenem resistance among E. coli and K. pneumoniae isolates. A total of 550 samples (pus, urine, sputum, etc) were subjected to culture. The antibiotic susceptibility for various antibiotics was studied by Kirby Bauers Disk Diffusion Test. Carbapenem resistance and Metallo-betalacatamase (MBL) production was detected using Modified Hodge Test and EDTA Disk Synergy Test respectively. Result: A total of 129 isolates (43%) were meropenem resistant out of which 42 isolates (14%) were MBL producing. Carbapenase production was noted in 42.1% of E.coli and45.8% of K. pneumoniae . Twelve percent of the E. coli and 20.8% of the K. pneumoniae were found to have prevalence of MBL producers respectively. Conclusion: High incidence of carbapenem resistance and MBL producers was noted in the isolates. Given the emerging pattern of resistance to these third line antimicrobials and limited new molecules it is imperative to frame a new antibiotic policy and its strict implementation.