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

Abstract

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. blaNDM was the most common gene (24.7%) found by PCR assay followed by blaKPC (14.9%), blaVIM (9.6%) and blaOXA-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.

Keywords

• carbapenemase producing gnb
• carbapenem resistant gnb
• carbapenemase encoding genes