Prevalence of Carbapenem Resistant Gram Negative Bacteria in Central Referal Hospital, Sikkim.

Pratibha Tamang; T. Shantikumar Singh; Jyotsna Kapil

Volume : VII, Issue : V, May - 2018

Prevalence of Carbapenem Resistant Gram Negative Bacteria in Central Referal Hospital, Sikkim.

Pratibha Tamang, T. Shantikumar Singh, Jyotsna Kapil

Abstract :

Carbapenems arebeta–lactam antibiotics, oftenconsidered asdrug ofchoice for treating infections caused by multi–drug resistant Gram negative bacteria.This study aimed in determingthe prevalence of carbapenem resistant Gram negative bacteria and detecting the production of carbapenemase by Modified Hodge Test(MHT).Antibiotic susceptibility testing was done by Kirby Bauer disc diffusion methodand carbapenemase detection by MHT.Out of the total 155 Gram negative bacterial isolates, the prevalence of carbapenem resistance was found to be 25.80% (40/155). The majority ofthe resistant isolates were detected among theICU patients (53.13%), followed by ward patients (19.30%) and least among OPD patients (11.11%).Carbapenem resistant isolates were obtainedmainly from urine sample (n=12), followed by pus (n=11), endotracheal secretion(n=10), blood (n=4) and sputum (n=3).Carbapenemase production was detected in 30% (12) of the resistant isolatesby MHT with thecarbapenemases production beinghighest in Escherichia coli (50%) and Proteusmirabilis(50%), followed by Klebsiellapneumoniae (42.9%), Pseudomonasaeruginosa (25%),Acinetobacterbaumannii (25%) and not detected in any of the resistant isolates of Enterobactercloacae, BurkholderiacepaciaandStenotrophomonasmaltophila.The prevalence of carbapenem resistant Gram negative bacteria in our hospital is much less than that reported from other studies.Moreover, MHTlacks specificity, giving false positive results in case of AmpCproducers and also lacks sensitivity as it weakly screens the New Delhi Metallo–beta–lactamase producers.