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Study on klebsiella pneumoniae carbapenemase and metallo beta lactamase enzymes in clinical isolates of gram negative bacilli

Author: 
Dr. Archana Bhat, K. and Dr. Nagarathnamma, T.
Subject Area: 
Health Sciences
Abstract: 

Background: Resistance to broad spectrum β-lactams mediated by Extended spectrum β-lactamases and AmpC β lactamases is an increasing problem worldwide. The advent of carbapenems heralded a new treatment option for serious bacterial infection. But carbapenemases have emerged and spread, leading to carbapenem resistance .Hence, it is necessary to know their incidence in the clinical isolates of the hospital, so as to formulate a policy of empirical therapy in high risk patients. Materials and methods: A total of 250 isolates of Gram negative bacilli isolated from various clinical samples received in the Department of Microbiology, BMC & RI were included in the study. Antibiotic susceptibility was done according to Kirby-Bauer disk diffusion method on Mueller Hinton agar and results were interpreted according to CLSI guidelines. Carbapenemases were screened and confirmed by CLSI recommended Modified Hodge test(MHT) and Phenyl boronic acid/Ethylene diamine tetra acetic acid (BA/EDTA) disk potentiation test. Results: The most common organism isolated was Escherichia coli (44%) followed by Klebsiella pneumoniae (29.6%). 3.2%, 12.8% and 3.6% were pure KPC, pure MBL and co-producer of KPC and MBL respectively. The BA/ EDTA disk potentiation test is better than MHT for detection of carbapenemase and MBL. Interpretation and Conclusion: The BA/ EDTA disk potentiation test is better than MHT for detection of carbapenemases and MBL and is a satisfactory and inexpensive method for characterizing the type of carbapenemase when PCR is not readily available. Thus the combined disc potentiation test could be used as a convenient screening method for carbapenemases.

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