Biomedicine

Abstract

Introduction and Aim: Emergence of resistance to carbapenems in clinical isolates of Klebsiella species is a matter of concern. This prospective study was carried out to determine the prevalence of carbapenem resistance in clinical isolates of Klebsiella species phenotypically and to confirm for the presence of bla NDM (New Delhi metallo--lactamase) and bla KPC (Klebsiella pneumoniae carbapenemase) genes in these isolates.
Materials and Methods: The 336 clinical isolates of Klebsiella species were tested for carbapenemase production by phenotypic tests; the Modified Hodge Test (MHT) and Combined Disc Test (CDT). The carbapenemase producers were further confirmed for presence of bla NDM and bla KPC genes using polymerase chain reaction (PCR).
Results: Resistance to carbapenem was seen in 34.52% of clinical isolates of Klebsiella species and majority of these isolates were from inpatient units (59.23%) of the Hospital. Maximum cases were seen in males (63.69%) and the positivity rate was high in > 61 years of age (27.08%). On genotypic characterization, bla NDM was the predominant (15.52%) gene detected as compared to bla KPC (10.34%) gene. However, these 2 genes could not be detected in some isolates suggesting other genes responsible for carbapenem resistance.
Conclusion: Emergence of resistance to carbapenem is a matter of concern. There was predominance of bla NDM gene in our hospital. Timely and accurate detection of resistance and rational use of second and third-line antibiotics would allow the early initiation of treatment for better patient outcome