Changing Trend in the Antibiotic Resistance Pattern of Klebsiella Pneumonia Isolated From Endotracheal Aspirate Samples of ICU Patients of a Tertiary Care Hospital in North India

Sharma, Abhishek; Thakur, Abhishake; Thakur, Neha; Kumar, V.; Chauhan, Ankit; Bhardwaj, Neha

doi:10.7759/cureus.36317

Cited by 16 publications

(14 citation statements)

References 21 publications

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“…The prevalence of MDR K. pneumoniae clinical isolates has been continuously increasing over the world. 38 The current study found that K. pneumoniae is resistant to most commonly used antibiotics. In our study, K. pneumoniae showed notable antibiotic resistance, the same as in the Wang et al findings.…”

Section: Discussionmentioning

confidence: 59%

Clinical and Molecular Profile of Carbapenem Resistant Klebsiella pneumoniae Infections in a Tertiary Care Hospital –Mangalore

Pattolath,

Adhikari,

Pai

2023

IDR

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Purpose Carbapenemase producing Klebsiella pneumoniae infection has increased in recent years, leading to limitations in treatment options. The present study was undertaken to detect the Carbapenemase-producing genes in K. pneumoniae , the risk factors for acquiring them, and their impact on clinical outcomes. Patients and Methods This prospective study included 786 clinically significant K . pneumoniae isolates. Antimicrobial susceptibility testing was done by conventional method, carbapenem-resistant isolates were screened by carba NP test, and positive isolates were further evaluated by multiplex PCR method. The patient’s clinical and demographic details, co morbidity, and mortality were collected. Multivariate analysis was performed to check risk factors for acquiring CRKP infection. Results The results of our study showed high prevalence of CRKP (68%). The variables subjected to the multivariate analysis found that diabetes, hypertension, cardiovascular disease, COPD, use of immunosuppressants, previous hospitalization history, previous surgery, and parenteral nutrition are found to be significantly associated with carbapenem resistant K. pneumoniae infection. Clinical outcomes revealed that patients in the CRKP group had higher risk of mortality and were discharged against medical advice, and they also had higher rate of septic shock. Most of the isolates carried blaNDM-1 and blaOXA-48 carbapenemase genes. Additionally, the co-existence of blaNDM-1 and blaOXA-48 was found in our isolates. Conclusion The prevalence of CRKP was alarmingly high in our hospital with the limited choice of antibiotics. This was associated with high mortality and morbidity with the increase in health care burden. While this information is important to treat critically ill patients with higher antibiotics, strict infection control practices need to be in place to prevent the spread of these infections in the hospital. Clinicians need to be aware of this infection to use appropriate antibiotics to save the lives of critically ill patients with the infection.

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Section: Discussionmentioning

confidence: 59%

Clinical and Molecular Profile of Carbapenem Resistant Klebsiella pneumoniae Infections in a Tertiary Care Hospital –Mangalore

Pattolath,

Adhikari,

Pai

2023

IDR

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“…In addition, they found that in 87.5% of study participants, Acinetobacter baumannii infections were resistant to the broad-spectrum antimicrobial carbapenem, reducing the number of available treatment choices. Similarly, a study by Sharma et al found that the sensitivity of Klebsiella pneumoniae to meropenem decreased from 15% in 2018 to 2.5% in 2022, while the sensitivity of Klebsiella to colistin decreased from 96% in 2018 to 28% in 2022 [2]. This AMR situation continues to escalate in India due to several key issues [3,4].…”

Section: Editorialmentioning

confidence: 97%

The Challenge of Antimicrobial Resistance in the Indian Healthcare System

Sharma¹,

Thakur²,

Thakur³

et al. 2023

Cureus

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The emergence and rapid spread of antimicrobial resistance (AMR) pose a grave threat to public health globally, and particularly so in India. With its unique combination of a dense population, a significant disease burden, and diverse healthcare practices, India stands at a critical juncture in the global battle against AMR. The implications of this escalating crisis are far-reaching, threatening decades of medical progress, undermining healthcare delivery, and posing potential roadblocks to the realization of several Sustainable Development Goals.AMR is a crisis within the Indian healthcare system as it severely hampers the effective treatment of infectious diseases, leading to higher mortality rates, longer hospital stays, and increased healthcare costs. Its rise could mark the return of the pre-antibiotic era, where common infections and minor surgeries could once again become life-threatening. Addressing the challenge of AMR in India requires a comprehensive, multifaceted, and well-coordinated response. From creating strong regulatory frameworks for antibiotic usage and improving diagnostic capabilities to fostering greater public awareness and promoting research into new antimicrobials, the strategies need to be as diverse and interconnected as the problem itself. This editorial will delve into the specificities of the AMR challenge within the Indian healthcare system, discuss potential strategies for mitigating the crisis, and evaluate the broader implications for public health and national policy. It will also highlight why India's response to this global health threat is crucial not only for the country but for the world at large.

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“…It is the colonizer of the gastrointestinal tract (GIT) and causes septicemia and pneumonia mediated by their endotoxins, cell wall, and polysaccharide. Infection is through contaminated hospital equipment and in between infected persons [13,28,29].…”

Section: Klebsiellamentioning

confidence: 99%

“…Sharma et al [29] 2023 Increasing antimicrobial resistance trend among the Klebsiella pneumoniae to higher antibiotics.…”

Section: Rosenthal Etmentioning

confidence: 99%

The Pattern and Impact of Hospital-Acquired Infections and Its Outlook in India

Thakkar,

Shanoo,

Gupta

et al. 2023

Cureus

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Nosocomial infections form one of the most challenging tasks to deal with in a hospital setting. The burden of hospital-acquired infections (HAI) significantly affects the patient's cost of medical treatment and seriously impacts the economy of a developing country like India. Haphazard antibiotic use for the treatment of these infections has led to the development of resistance among the microbes, and factors that complicate microbial eradication further worsen the scenario. A large percentage of the HAI are preventable by simply following up various protocols which when supported by judicious antibiotic use can declutter the severity of the problem. Organized infection control measures, trained hospital staff, and continuous surveillance of HAI in healthcare settings will help deal with nosocomial infections. Although the ability to deal with HAI in a patient might determine his survival after acquiring a nosocomial infection, prevention remains the best option at all times. Lowering down the burden of nosocomial infections is of utmost importance since it contributes significantly to the overall resource utilization of the hospital and the country. Implementing the use of nanoparticles and nanotechnology in delivering target-specific drugs might be helpful in preventing antibiotic resistance. Taking into account reports of nosocomial infection patterns in various centres of India, the seriousness and consequences of HAI are uncovered in this article.

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Changing Trend in the Antibiotic Resistance Pattern of Klebsiella Pneumonia Isolated From Endotracheal Aspirate Samples of ICU Patients of a Tertiary Care Hospital in North India

Cited by 16 publications

References 21 publications

Clinical and Molecular Profile of Carbapenem Resistant Klebsiella pneumoniae Infections in a Tertiary Care Hospital –Mangalore

Clinical and Molecular Profile of Carbapenem Resistant Klebsiella pneumoniae Infections in a Tertiary Care Hospital –Mangalore

The Challenge of Antimicrobial Resistance in the Indian Healthcare System

The Pattern and Impact of Hospital-Acquired Infections and Its Outlook in India

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