Phenotypic detection of Carbapenemase production and difference in antimicrobial susceptibility pattern in clinical isolates of Klebsiella pneumoniae at a Medical College Hospital in Vidarbha region
Journal Title: Indian Journal of Microbiology Research - Year 2017, Vol 4, Issue 3
Abstract
Introduction: Carbapenemases are one of the common β-lactamases seen in Klebsiella pneumoniae that are responsible for multi drug resistance. Detection of resistance in these bacteria is necessary for formulation of infection control policies. The hidden resistance of this bacteria is critical to diagnose. To address this problem, the present study aims to detect Carbapenemase production and antimicrobial susceptibility patterns in clinical isolates of Klebsiella pneumoniae at the present setting. Materials and Method: A total of 438 strains of Klebsiella pneumoniae were isolated and subjected to Carbapenemase detection by Screening method using Imepenem (10 µg) disc. Modified Hodge test and Combined disc diffusion test along with E-test was done to confirm carbapenemase production followed by antimicrobial susceptibility testing. E-test was considered to be gold standard. Results: Total 34/438 (7.76%) carbapenem resistant isolates were obtained. The carbapenemase positive isolates were predominantly isolated from Burns wards (14.61%). E-test considering it as gold standard test confirmed all 34 of these as carbapenemase producers. Out of 34, MHT detected 31and CDT detected 32 isolates as positive for carbapenemase production. They were highly resistant to cefotaxime, and ceftazidime (91.18%). Conclusion: Screening for Carbapenemase production needs to be carried out routinely in every clinical diagnostic facility. There is a need for rational use and strict adherence to the concept of “reserve drugs” to minimize the misuse of available antimicrobials. The findings of this study emphasize the need for a continuous surveillance in the ICUs and different hospital wards to detect the resistant strains.
Authors and Affiliations
Apurva Parate, Rajesh Karyakarte, Nitin Ambhore
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