Prevalence of carbapenemase-producing organisms in a tertiary care hospital in Ludhiana

Mathias, Anuniti; Oberoi, Aroma; John, Mary; Alexander, Vipin Sam

doi:10.4103/2348-3334.190574

Cited by 2 publications

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“…These findings are in line with studies reported from Punjab, India. 63 The MHT has a sensitivity and specificity of 96% and 84%, respectively, for detection of the OXA-48 gene. 64 CLSI-recommended methods such as the CarbaNP test and mCIM were unavailable in our settings; the MHT was used for confirmation.…”

Section: Discussionmentioning

confidence: 99%

Detection of OXA-48 Gene in Carbapenem-Resistant Escherichia coli and Klebsiella pneumoniae from Urine Samples

Gurung¹,

Kafle²,

Dhungel³

et al. 2020

IDR

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Introduction: Resistance to carbapenem in Gram-negative bacteria is attributable to their ability to produce carbapenemase enzymes. The main objective of this study was to detect the presence of blaOXA-48 genes in carbapenem-resistant uropathogenic Escherichia coli and Klebsiella pneumoniae isolated from urine samples from patients attending Alka Hospital, Jawalakhel, Lalitpur, Nepal. Methods: A total of 1013 mid-stream urine samples were collected from patients with suspected urinary tract infection (UTI) between April and September 2018. The identified isolates underwent antibiotic susceptibility testing using the modified Kirby-Bauer discdiffusion method. Phenotypic carbapenemase production was confirmed by the modified Hodge test, and the blaOXA-48 gene was detected using conventional polymerase chain reaction. Results: Out of 1013 urine samples, 15.2% (154/1013) had bacterial growth. Among the isolates, 91.5% (141/154) were Gram-negative bacteria, and E. coli was the most common bacterial isolate (62.9%; 97/154), followed by K. pneumoniae 15.6% (24/154). Among 121 bacterial isolates (97 E. coli isolates and 24 K. pneumoniae isolates), 70.3% (52/121) were multidrug-resistant E. coli and 29.7% (22/121) were multidrug-resistant K. pneumoniae. In addition, 9.1% (11/121) were carbapenem resistant (both imipenem and meropenem resistant). Development of multidrug resistance and development of carbapenem resistance were significantly associated (p<0.05). Of the 11 carbapenem-resistant isolates, only seven were carbapenemase producers; of these, 28.6% (2/7) were E. coli, 72.4% (5/7) were K. pneumoniae and 42.8% (3/7) had the blaOXA-48 gene. Of the three bacterial isolates with the blaOXA-48 gene, 33.3% (1/3) were E. coli and 66.7% (2/3) were K. pneumoniae. Conclusion: One in ten isolates of E. coli and K. pneumoniae were carbapenem resistant. Among carbapenem-resistant isolates, one-third of E. coli and two-thirds of K. pneumoniae had the blaOXA-48 gene. OXA-48 serves as a potential agent to map the distribution of resistance among clinical isolates.

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Section: Discussionmentioning

confidence: 99%

Detection of OXA-48 Gene in Carbapenem-Resistant Escherichia coli and Klebsiella pneumoniae from Urine Samples

Gurung¹,

Kafle²,

Dhungel³

et al. 2020

IDR

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Prevalence and Characterization of Multi Drug Resistant Gram Negative Bacilli Isolates from a Tertiary Care Centre of Western U.P., India

Mohan¹,

Farooq²

2019

J Pure Appl Microbiol

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Infections with MDR GNB are associated with mortality rates 21% higher than those of non resistant GNB and results in longer in patient stays and higher treatment costs. Several Indian studies have reported prevalence of carbapenemase producing Enterobacteriaceae, Pseudomonas and Acinetobacter species in a range of 11% to 81%, because of ample variation reported in prevalence and incidence of carbapenemases reported from different geographical region from time to time, we aimed to determine prevalence of carbapenemase producing organism and carbapenemase encoding genes among clinical MDR-GNB isolates from our area and also to assess the performance of the phenotypic tests. This was a cross sectional study. A total of 510 multi drug resistant isolates included were subjected to MHT and MBL E strip Test to detect carbapenamase production. In addition these isolates were subjected to PCR assay to confirm presence of carbapenamase genes encoding for these enzymes. The study found carbapenemase prevalence of 58.6% by phenotypic tests. bla NDM was the most common gene (24.7%) found by PCR assay followed by bla KPC (14.9%), bla VIM (9.6%) and bla OXA-48 (8.6%). Awareness of the prevalence and incidence of the carbapenem resistance and carbapenemase enzymes is crucial in the prevention of their spread and selection of appropriate treatment options. Study shows high prevalence rate of carbapenam resistant gram negative bacilli in this area, which indicates danger of limited treatment options and requirement of continuous detection of these cases to limit spread of resistant cases.

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Prevalence of carbapenemase-producing organisms in a tertiary care hospital in Ludhiana

Cited by 2 publications

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<p>Detection of OXA-48 Gene in Carbapenem-Resistant <em>Escherichia coli</em> and <em>Klebsiella pneumoniae</em> from Urine Samples</p>

<p>Detection of OXA-48 Gene in Carbapenem-Resistant <em>Escherichia coli</em> and <em>Klebsiella pneumoniae</em> from Urine Samples</p>

Prevalence and Characterization of Multi Drug Resistant Gram Negative Bacilli Isolates from a Tertiary Care Centre of Western U.P., India

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