Prevalence of carbapenem resistant enterobacteriaceae at a tertiary care institute: need for policy

Introduction: Resistance to broad-spectrum antimicrobials is a well recognized problem among Enterobacteriaceae. Carbapenems have served as an important antimicrobial class for the treatment of these organisms. The emergence and dissem¬ination of carbapenem resistant enterobacteriaceae (CRE) in recent times represents a serious threat to public health. Aim: The study was conducted to detect the prevalence of carbapenem resistance in members of Enterobacteriaceae and to detect the enzymes Klebsiella pneumoniae carbapenemase (KPC) and Metallo-Beta lactamases (MBL) in resistant isolates Material and methods: The study was carried out in the Department of Microbiology, at Bhagat Phool Singh Govt. Medical College for Women, Haryana. The bacterial isolates, obtained from various clinical samples, were identified according to standard microbiological procedures. All isolates belonging to Enterobacteriaceae family like Escherichia coli, Klebsiella species and Citrobacter species were included in the study. All these isolates were screened for carbapenem resistance by disc diffusion method according to CLSI. Results: A total of 54 (13.77%) isolates of CRE or¬ganisms were obtained among 392 Enterobacteriaceae isolates. The carbapenem resistance rate was highest among ward patients. Maximum CRE was cultured from urine samples (50.0%), followed by pus samples (24.0%). The most predominant species among CRE isolates was Escherichia coli in the present study. Conclusion: Over the past decade, the emergence of carbapenem resistant Enterobacteriaceae has become a formidable threat to public health. As a first step towards control, the capacity for resistance detection and surveillance in low-resource countries needs to be improved in order to collect more reliable data on the worldwide distribution of CRE.