Carbapenemase producing isolates

Carbapenem-resistant Enterobacteriaceae are considered by WHO as “critical” priority pathogens for which novel antibiotics are urgently needed. The dissemination of carbapenemase-producing Escherichia coli (CP-Ec) in the community is a major public health concern. However, the global molecular epidemiology of CP-Ec isolates remains largely unknown as well as factors contributing to the acquisition of carbapenemase genes.

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Carbapenems are one of the β-Lactam antibiotics with a broad spectrum of antibacterial activity. Inappropriate use of this antibiotic can produce resistance strains by production of carbapenemases enzyme. The Klebsiella pneumoniae carbapenemase (KPC) is the most important mechanism of enzymatic resistance seen in Enterobacteriaceae isolated especially Klebsiella pneumoniae. The aim and objectives of this study was isolation and detection of the Carbapenem resistant Klebsiella species strains with phenotypic methods. Out of 11248 samples, 602 Klebsiella species (33.

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Microbiological infection plays vital role in determining the outcome as well as cost and duration of the hospital stay for patients admitted in ICU setup. Of late nosocomial infections especially ventilator associated pneumonias (VAP) have been recognized to be associated with significant morbidity and mortality in intubated patients. It is of critical importance to do regular surveillance of important pathogen (like Methicillin resistant staphylococcus aureus (MRSA), extended spectrum beta lactamase (ESBL) and carbapenemase producers) and its resistance pattern.

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Enterobacteriaceae cause protean infections and are the common Gram negative isolates in a microbiology laboratory. Spectrum of multi-drug resistance includes AmpC, Extended spectrum beta lactamase and carbapenemase production with others. This was a cross sectional study to determine susceptibility pattern of AmpC and extended spectrum beta lactamase producing isolates against different antimicrobials.

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Resistance to carbapenems are because of various mechanisms like mutations in the outer membrane proteins like Opr D causing decreased permeability of the drugs, the carbapenem hydrolyzing enzymes–carbapenemases and the efflux mechanisms. Carbapenem resistance was studied in 140 non-repeat clinical isolates of Pseudomonas aeruginosa in a tertiary care hospital. Imipenem resistance was detected using Kirby Bauer’s standard disc diffusion method. MIC for Imipenem was detected in all resistant isolates using E-test strips.

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Klebsiella pneumoniae is a common organism causing bronchopneumonia and is a known pathogen in non-healing diabetic foot infections. KPC strains of Klebsiella pneumonia from Pus and Sputum samples were isolated in Thanjavur Medical College from March to April 2018 which show resistance to beta lactam antibiotics, beta lactamase inhibitors and Carbapenems and confirmed the responsible blaKPC gene by PCR. The study signifies the importance of rational usage of antibiotics.

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To isolate common organisms from suspected cases of septicemia with their antimicrobial susceptibility pattern and know the prevalence of MDR strains by detecting MRSA isolates, ESBL, AmpC and Carbapenemase production. Blood samples were collected from suspected cases of septicemia and incubated in BacT/ALERT 3D. Subculture was done on Blood agar, nutrient Agar, MacConkey Agar and Chocolate Agar and identification was done by standard biochemical reactions.

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This study was done to evaluate the performance of Carba NP test for the detection of carbapenemase producing Gram negative bacilli. In total, 330 Gram negative bacilli isolates were subjected to Antibiotic Susceptibility Testing, Epsilometer test, Modified Hodge test with meropenem to determine the presence of resistance among carbapenem group of drugs. 44/ 330(13.3%) showed resistance pattern.

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Antibiotic resistance is observed in both pathogenic and normal commensal flora. Gastrointestinal tract may serve as a reservoir for carbapenem resistant Enterobacteriaceae (CRE), resulting in cross transmission within / among health care settings. Awareness of the fecal carriage of Extended spectrum Beta lactamase (ESBL) and CarbapenemaseProducing Enterobacteriaceae (CPE) bacteria is very important for the clinicians, microbiologists, infection control practitioners and epidemiologists.

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K. pneumoniae is responsible for a wide variety of hospital and community-acquired infections, affecting patients with normal immune systems as well as those with pre-existing conditions. The Carbapenems are β-lactam antibiotics that are used in the treatment of infections caused by Extended Spectrum beta-Lactamases (ESBL) producing gram negative bacteria (GNB). Carbapenem antibiotics are considered the drugs of choice for the treatment of ESBL -producing Enterobacteriaceae and other multidrug resistant bacteria.

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Carbapenemase producing carbapenem resistant Enterobacteriacea were almost non-existent till 1990s but nowadays they are routinely encountered in hospitals. KPC producing Klebsiella pneumoniae were the first to develop and occur commonly. Lately NDM producing Enterobacteriaceae have emerged. IMP and VIM genes in Carbapenem resistant Enterobacteriaecae have started to emerge but the prevalence is low.

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One of the common causes of morbidity and mortality following burn injury is infections. The emergence of metallo-β-lactamase (MBL) in Gram negative bacilli (GNB) has reduced the available therapeutic options for effective treatment. Therefore, for screening of carbapenemase producers, a simple and inexpensive testing method is essential. To know the prevalence of MBL production in various gram negative isolates, to evaluate different phenotypic methods to detect MBL production and to find out antibiotic sensitivity profile of MBL producing gram negative bacilli.

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