DISSEMINATION AND DETECTION OF CARBAPENEMASES PRODUCING GRAM-NEGATIVE RODS

Abstract

Objective:

To evaluate the burden of carbapenemases producers among carbapenem-resistant isolates. Study Design: Cross-sectional study. Place and Duration of Study: This cross-sectional study was conducted at microbiology lab, Pathology department, Allama Iqbal Medical College Lahore, from Jul 2016 to Apr 2017.

Material and Methods:

A total of 12126 clinical specimens were enrolled through a non-probability/consecutive sampling technique, every sample was processed for bacterial culture, identification was done on the basis of colonial morphology, Gram stain, and biochemical profile. All those isolates that were Gram-negative rods, were processed for carbapenemases detection by Modified Hodge test (MHT) in accordance with CLSI 2016.

Results:

Out of total n=12126 samples, culture positive were 35.9% (n=4361) of which 40.5% (n=1770) were Gram-negative rods, among these 9.6% (n=170) were carbapenem-resistant isolates of which 50% (n=85) were carbapanamases producers (MHT positive). Organisms wise carbapenem resistance was detected in Acineto- bacter species 44.%, Pseudomonas species 34%, E.coli 7%, Klebsiella species 8%, Proteus species 3%, Citrobacter species 1%, Enterobacter species 0.7% Among these isolates MHT positivity was as followed Acinetobacter species were 53%, Pseudomonas species 51%, E.coli 36%, Klebsiella species 50%, Proteus species 20%, Citrobacter species 66%, Enterobacter species 50%, department wise distribution of carbapenemases producer showed that among total sample received from surgical units 51.4%, ICU 65.3% medical units 43.5%, pediatric ward 71.4%, orthopedic 11.1% neurosurgery 20%, other wards 55.1% were MHT positive. The almost similar resistant pattern was observed in MHT positive and negative isolates.

Conclusion:

Emergence of carbapenem resistance is an alarming situation in clinical settings.resu