Current trends of Carbapenemase Production Amongst Multi-drug Resistant Gram-Negative Bacteria in a Tertiary-Care Hospital in West Bengal

Abstract

Background: Carbapenemase production, being encoded on plasmids, can lead to transferable resistance and outbreaks with a community/hospital setup.
Objectives: Our aim was to study the prevalence of Carbapenemase producing multi-drug-resistant gram-negative bacteria in different zones of our hospital to aid in antimicrobial resistance surveillance.
Material and Methods: All clinical samples sent for culture and sensitivity study during the study period were followed up for detection of Carbapenemase production by phenotypic tests such as Carbapenem Inactivation tests and Carba NP test. Subsequently, molecular testing was done by PCR using five gene targets - bla_KPC, bla_NDM, bla_IMP, bla_VIM, and bla_OXA-48.
Results: The overall prevalence of Carbapenemase production among strains of Klebsiella pneumoniae, Escherichia coli, Acinetobacter baumannii and Pseudomonas aeruginosa was 45.25%. Klebsiella pneumoniae was found to be the most common Carbapenemase producer (45%). Metallo-β-lactamase was the predominant phenotypic expression and the most common gene was NDM (74%).
Conclusions: The high prevalence of Carbapenemase producing bacteria in intensive care zones is a cause of alarm. Early detection of resistance, stringent infection prevention and control measures and antimicrobial stewardship are essential to preserve the usefulness of Carbapenems and improve therapeutic outcomes in patients.