Abstract

CARBAPENEMS RESISTANCE IN GRAM-NEGATIVE BACILLI ISOLATES FROM RESPIRATORY TRACT SAMPLES OF PATIENTS IN INTENSIVE CARE UNITS

Vandanan B. Rajput* and Dr. Jigna P. Naik

Abstract

Carbapenems are preferred antibiotics for severe infections in ICUs. Its widest antibacterial spectra offers realistic option for monotherapy in ICUs, but in recent year clinical utility of carbapenems are under a serious threat, due to production of Metallo-beta-Lactamase (MBLs). Gram-negative bacterial infections are particular concern, especially MBLs producing in intensive care units (ICUs). Detection of MBLs among Gram-negative bacilli (GNBs) is crucial for the optimal treatment of patients and to control the spread of resistance. This study was conducted to determine carbapenems-resistant and the proportion of MBLs producer among multi-drug resistant (MDR) GNBs isolated from respiratory tract samples of patients admitted in various ICUs. Total 70 non-duplicate GNBs from respiratory tract samples were isolated, identified and subjected to antibiotics susceptibility testing. Isolates were screened for MBLs production and confirmed by phenotypic confirmatory tests. Out of 70 GNBs, 38 isolates were found to be MDR, 31 isolates were found to be imipenem resistant, 34 isolates were found to be meropenem, ertapenem and doripenem resistant. These 34 carbapenems resistant isolates were found MBLs producer by phenotypic screening and confirmatory test, with broad spectrum resistance profile.The results suggested that the resistance to carbapenems agents in the present study is due MBLs production. Considering the emergence characteristic of MBLs, its surveillance becomes important to control the transmission of this resistance mechanism.

Keywords: Intensive Care Units (ICUs), Respiratory tract sample, Gram negative bacilli (GNBs), Carbapenems resistance, Metallo-Beta-Lactamase (MBLs).