Abstract :
Background: The incidence of carbapenem-resistant bacteria causing community-acquired and healthcare-associated infections has significantly increased globally due to the irrational use of antibiotics. Among the Enterobacteriaceae family, primarily Klebsiella pneumoniae, are most commonly responsible for deadly infections. Carbapenems are the last-resort medications for treating drug-resistant Gram-negative bacterial infections. But recently, it has been observed that there has been an increase in the prevalence of carbapenem-resistant Klebsiella species resulting in treatment failure. Hence, it is imperative that a suitable and economical phenotypic method to be used to identify Klebsiella pneumoniae that produce carbapenemase in order to prevent infections from spreading further.
Materials and Methods: A hospital-based cross-sectional study was carried out in Microbiology laboratory. Klebsiella pneumoniae was isolated from various clinical sample and were classified using a thorough clinical history into hospital-acquired and community-acquired infections. Antibiotic susceptibility testing (AST) was performed by the Kirby–Bauer disc diffusion method. The Modified Carbapenemase Inactivation Test (m-CIM) was performed to detect carbapenemase producers.
Results: A total of 123 Klebsiella pneumonia were isolated from various clinical sample. Out of which, 71(58%) were associated with Hospital acquired infection, 52(42%) were causing Community acquired infections and 33(27%) were positive for m -CIM test. Tigecycline showed the highest sensitivity 46(89%), followed by meropenem and imipenem 45(87%) in Community acquired infections. Carbapenemase producing K. pneumonia showed higher resistance to Ampicillin (100%) and Piperacillin –Tazobactam (100%).
Conclusion: The rate of carbapenemase production was high in the K. pneumoniae isolates. Tigecycline could be the drug of choice for the empirical treatments of carbapenemase-producing K. pneumoniae. Our study provides a better understanding of antibiotic resistance threat and enables physicians to select the most appropriate antibiotics.
Keyword :
Hospital infection, Community acquired infection, Carbapenemase, Klebsiella pneumonia, Carbapenems, Bacterial antibiotic resistance.