Molecular characterization of extended spectrum β-lactamase and carbapenemase producing klebsiella pneumoniae from a tertiary care hospital

Beena Hosdurg Bhaskar, Shalini Shenoy Mulki, Sangeetha Joshi, Ranjeeta Adhikary, Bhavana Malavalli Venkatesh

Research output: Contribution to journalArticle

Abstract

Objective: The extended-spectrum beta-lactamase (ESBL) and carbapenemase producing gram-negative bacteria among the members of Enterobacteriaceae are of major health concern globally. The present study was carried out to determine proportion and genetic characterization of ESBL and carbapenemase producing Klebsiella pneumoniae strains isolated from intensive care units of a tertiary care hospital. Materials and methods: A total of 250 non-duplicate K. pneumoniae isolates were recovered from various clinical specimens from our intensive care units from May 2014 to May 2015. Antibiotic susceptibility testing was performed as recommended by Clinical and Laboratory Standard Institute. Phenotypic identification of ESBL and carbapenemase producing isolates were confirmed by the double-disk synergy test, modified Hodge test, imipenem and imipenem-EDTA combined test, respectively. Molecular characterization of β-lactamase genes were performed by polymerase chain reaction. Results: Out of 250 Klebsiella pneumonaie, 84% isolates were ESBL producers, 66% were carbapenem resistant based on their reduced susceptibility to imipenem, meropenem and ertapenem. Among these 165 carbapenem resistant isolates, 9.7% were positive for blaNDM-1 and these isolates were also found to be positive for one or more bla genes. Co-carriage of AmpC in ESBL and carbapenem resistant isolates were 7.8% and 3.6%, respectively and were negative for blaKPC genes. Conclusion: The study indicated the prevalence of ESBLs and blaNDM-1, with additional bla genes and AmpC among the K. pneumoniae isolates in our intensive care units. NDM-1 producing Enterobacteriaceae is a growing health care problem. Detection of the prevalence of antibacterial resistance pattern helps towards improved antibiotic policy and empirical antibiotic treatment.

Original languageEnglish
Pages (from-to)61-66
Number of pages6
JournalIndian Journal of Critical Care Medicine
Volume23
Issue number2
DOIs
Publication statusPublished - 01-01-2019
Externally publishedYes

Fingerprint

Klebsiella pneumoniae
Tertiary Healthcare
beta-Lactamases
Tertiary Care Centers
Carbapenems
Imipenem
Intensive Care Units
meropenem
Enterobacteriaceae
Anti-Bacterial Agents
Genes
Klebsiella
Gram-Negative Bacteria
Edetic Acid
Cross-Sectional Studies
carbapenemase
Delivery of Health Care
Polymerase Chain Reaction
Health

All Science Journal Classification (ASJC) codes

  • Critical Care and Intensive Care Medicine

Cite this

Bhaskar, Beena Hosdurg ; Mulki, Shalini Shenoy ; Joshi, Sangeetha ; Adhikary, Ranjeeta ; Venkatesh, Bhavana Malavalli. / Molecular characterization of extended spectrum β-lactamase and carbapenemase producing klebsiella pneumoniae from a tertiary care hospital. In: Indian Journal of Critical Care Medicine. 2019 ; Vol. 23, No. 2. pp. 61-66.
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abstract = "Objective: The extended-spectrum beta-lactamase (ESBL) and carbapenemase producing gram-negative bacteria among the members of Enterobacteriaceae are of major health concern globally. The present study was carried out to determine proportion and genetic characterization of ESBL and carbapenemase producing Klebsiella pneumoniae strains isolated from intensive care units of a tertiary care hospital. Materials and methods: A total of 250 non-duplicate K. pneumoniae isolates were recovered from various clinical specimens from our intensive care units from May 2014 to May 2015. Antibiotic susceptibility testing was performed as recommended by Clinical and Laboratory Standard Institute. Phenotypic identification of ESBL and carbapenemase producing isolates were confirmed by the double-disk synergy test, modified Hodge test, imipenem and imipenem-EDTA combined test, respectively. Molecular characterization of β-lactamase genes were performed by polymerase chain reaction. Results: Out of 250 Klebsiella pneumonaie, 84{\%} isolates were ESBL producers, 66{\%} were carbapenem resistant based on their reduced susceptibility to imipenem, meropenem and ertapenem. Among these 165 carbapenem resistant isolates, 9.7{\%} were positive for blaNDM-1 and these isolates were also found to be positive for one or more bla genes. Co-carriage of AmpC in ESBL and carbapenem resistant isolates were 7.8{\%} and 3.6{\%}, respectively and were negative for blaKPC genes. Conclusion: The study indicated the prevalence of ESBLs and blaNDM-1, with additional bla genes and AmpC among the K. pneumoniae isolates in our intensive care units. NDM-1 producing Enterobacteriaceae is a growing health care problem. Detection of the prevalence of antibacterial resistance pattern helps towards improved antibiotic policy and empirical antibiotic treatment.",
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Molecular characterization of extended spectrum β-lactamase and carbapenemase producing klebsiella pneumoniae from a tertiary care hospital. / Bhaskar, Beena Hosdurg; Mulki, Shalini Shenoy; Joshi, Sangeetha; Adhikary, Ranjeeta; Venkatesh, Bhavana Malavalli.

In: Indian Journal of Critical Care Medicine, Vol. 23, No. 2, 01.01.2019, p. 61-66.

Research output: Contribution to journalArticle

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