“TO STUDY THE PREVALENCE OF KLEBSIELLA PNEUMONIAE AND ITS ANTIBIOGRAM WITH SPECIAL REFERENCE TO CARBAPENEM RESISTANCE IN PATIENTS ATTENDING A TERTIARY CARE HOSPITAL”.
Main Article Content
Keywords
MDR, Prevalence, K.pneumoniae, ESBL, CRKP
Abstract
Introduction: The emergence of multidrug-resistant (MDR) strains of K. pneumoniae that produce carbapenemase and extended-spectrum β-lactamase (ESBL) has made the pathogen a significant hazard to both public and clinical health.Carbapanem-resistant K. pneumoniae (Cr-KPN) is a pathogen that affects people worldwide, with prevalence in low, middle and upper income countries. Resistance to carbapenem is mediated by two primary mechanisms. First, Cr-KPN is able to produce β-lactamases with the ability to hydrolyze cephalosporins such AmpC cephalosporinase. The second mechanism is mediated by the production of a β-lactamases capable of hydrolyzing most β-lactams antibiotics including carbapenems.
Aim and Objective: To Study the Prevalence of Klebsiella Pneumonia and its Antibiogram with Special Reference to Carbapenem Resistance in Patients Attending a Tertiary Care Hospital.
Material and methods: This was a cross sectional study carried out in the Department of Microbiology for a period of 1 year i.e, during August 2021 to August 2022 at Index Medical College, Hospital and Research Centre (IMCHRC), Indore (M.P.) The study included all the patients of OPD and IPD. Samples like urine, sputum, ET tube, pleural fluid,pus, CSF, blood and Ascitic fluid were included in this study. Carbapenemase resistance was detected phenotypically by MHT, mCIM and eCIM methods according to the CLSI guidelines 2021.
Results: In the present study a total of 430 clinical samples were studies, out of which 160 (37.20 %) samples showed growth of K. pneumoniae while 270 (62.8 %) samples showed growth of bacteria other than K. pneumoniae or sterile samples. 69.37% (n=111) of total Klebsiella isolates were carbapenem resistant (suggestive of Carbapenemase producers) by Kirby-Bauer disc diffusion with the prevalence of 69.37%. It was also observed that the ratio of Males 68 ( 61.2%) were more as compared to the females 43 (38.7%) with the most common age group being ›60 years in both the sexes with Sputum being the highest clinical isolated followed by urine, pus and least for Pleural fluid, CSF, blood, ET Aspirate.
The results indicate the phenotypic detection mCIM combined with eCIM showed high sensitivity and specificity to detect carbapenemase producing K.pneumoniae compared with MHT.
Conclusion: There aren't many options for treating infections caused by K. pneumoniae that produces carbapenemase; tigecycline and colistin may be the best medications. In addition, to determine the best empirical antibiotic therapy and stop the spread of MBL-producing bacteria in a hospital setting, routine surveillance of these microorganisms is required.
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Divya Srivastava
Ph.D. Scholar, Department of Microbiology, Index Medical College, Hospital & Research Centre, Malwanchal University, Indore, Madhya Pradesh, India
Ritika Tiwari
Tutor, Department of Microbiology, Uma Nath Singh Autonomous State Medical College, Jaunpur, India
Nausheen Begum
Infection Control Officer, Department of Microbiology, Autonomous State Medical College, Bahraich, Uttar Pradesh, India
Madhurendra Rajput Singh
Professor and Head, Department of Microbiology, Index Medical College, Hospital & Research Centre, Malwanchal University, Indore, Madhya Pradesh, India