• Saudi Med J · Mar 2022

    Phenotypic and genotypic detection of carbapenemase production among gram negative bacteria isolated from hospital acquired infections.

    • Sreeja K Vamsi, Rama S Moorthy, Mary N Hemiliamma, Rama B Chandra Reddy, Deepak J Chanderakant, and Shravani Sirikonda.
    • From the Department of Microbiology (Sreeja Vamsi); Manipal Academy of Higher Education; Karnataka, from the Department of Microbiology (Moorthy); Palamur Biosciences Pvt. Ltd., from the Department of Microbiology (Hemiliamma, Chandra Reddy); from the Department of Community Medicine (chanderakant); and from the Department of Microiology (Sirikonda); Sri Venkata Sai Medical College and Hospital, Telangana, India.
    • Saudi Med J. 2022 Mar 1; 43 (3): 236-243.

    ObjectivesTo identify the carbapenemase producing Gram-negative bacteria (GNB) by phenotypic methods and to confirm the presence of resistant genes using real-time polymerase chain reaction (PCR).MethodsThis was a prospective study carried out at the Department of Microbiology, Sri Venkata Sai Medical College and Hospital, Mahabubnagar, India, from March 2018-2021. All samples were screened for carbapenem resistance by disc diffusion method and the VITEK®2 compact system (bioMérieux, France). Detection of carbapenemase was carried out using RAPIDEC®CARBA NP test (Biomeriux Private Limited, South Delhi, India), screening for metallo-β-lactamases (MBL) was carried out by double disk synergy test (DDST), and genotypic characterization by real-time PCR.ResultsAmong the 1093 Gram-negative bacilli identified, 220 (17.0%) were resistant to carbapenems by both tested methods. Carbapenemase detection using the RAPIDEC®CARBA NP test indicated that 207 (94.0%) were carbapenemase producers, of which 189 (91.2%) were MBL producers. The most common carbapenemase genes identified were New Delhi metallo-β-lactamase (NDM; 47.3%), followed by the co-existence of genes in combination of NDM, with Verona integron-mediated metallo-β-lactamase (VIM; 39.6%), VIM and oxacillin hydrolyzing enzymes-48 (OXA-48; 4.3%), and OXA-48 (1.4%).No gene of active on imipenem, Klebsiella pneumonia carbapenemase, VIM, or OXA-48 alone was detected.ConclusionThis study suggests routine carbapenem resistance testing among multi-drug resistant-GNBs, as most of these infections occur in hospitals. In addition, there is a possibility that these highly antibiotic-resistant genes could spread to other bacteria resulting in further dissemination.Copyright: © Saudi Medical Journal.

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