Molecular Characterization of Extended Spectrum β-lactamase and Carbapenemase Producing Klebsiella pneumoniae from a Tertiary Care Hospital

• Published in: Indian journal of critical care medicine 2019-02, Vol.23 (2), p.61-66
• Main Authors: Bhaskar, Beena Hosdurg, Mulki, Shalini Shenoy, Joshi, Sangeetha, Adhikary, Ranjeeta, Venkatesh, Bhavana Malavalli
• Format: Article
• Language: English
• Subjects: Original
• ISSN: 0972-5229; 1998-359X
• DOI: 10.5005/jp-journals-10071-23118

The extended-spectrum beta-lactamase (ESBL) and carbapenemase producing gram-negative bacteria among the members of Enterobacteriaceae are of major health concern globally. The present study was carried out to determine proportion and genetic characterization of ESBL and carbapenemase producing strains isolated from intensive care units of a tertiary care hospital. A total of 250 non-duplicate isolates were recovered from various clinical specimens from our intensive care units from May 2014 to May 2015. Antibiotic susceptibility testing was performed as recommended by Clinical and Laboratory Standard Institute. Phenotypic identification of ESBL and carbapenemase producing isolates were confirmed by the double-disk synergy test, modified Hodge test, imipenem and imipenem-EDTA combined test, respectively. Molecular characterization of β-lactamase genes were performed by polymerase chain reaction. Out of 250 , 84% isolates were ESBL producers, 66% were carbapenem resistant based on their reduced susceptibility to imipenem, meropenem and ertapenem. Among these 165 carbapenem resistant isolates, 9.7% were positive for and these isolates were also found to be positive for one or more genes. Co-carriage of AmpC in ESBL and carbapenem resistant isolates were 7.8% and 3.6%, respectively and were negative for genes. The study indicated the prevalence of ESBLs and , with additional genes and AmpC among the isolates in our intensive care units. NDM-1 producing Enterobacteriaceae is a growing health care problem. Detection of the prevalence of antibacterial resistance pattern helps towards improved antibiotic policy and empirical antibiotic treatment. Beena HB, Shenoy SM, Molecular Characterization of Extended Spectrum β-lactamase and Carbapenemase Producing from a Tertiary Care Hospital. Indian J of Crit Care Med 2019;23(2):61-66.