Prevalance of Carbapenemase Production Among Clinical Gram-Negative Isolates in Bangladesh: A Comprehensive Study Using Disc Potentiation Test (DPT) Method
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Background
The prompt identification of carbapenemases, particularly Klebsiella pneumoniae carbapenemases (KPC) and Metallo-β-lactamase (MBL) produced by Klebsiella pneumoniae and Enterobacteriaceae , is imperative in stemming the spread of pathogens carrying these antibiotic-resistant attributes. This retrospective study seeks to delve into the clinical and microbiological characteristics of patients affected by gram-negative bacteria producing KPC and MBL, shedding light on their profiles and impacts.
Methods
We analyzed 147 clinical isolates from tertiary care hospitals in Dhaka, Bangladesh. Bacterial identification and Minimum inhibitory concentration (MIC) analysis were performed using conventional culture and VITEK ® 2 compact system. Carbapenem non-susceptibility (Cns) was defined as a minimum inhibitory concentration (MIC) of ≥1 µg/ml for Enterobacteriaceae while Pseudomonas aeruginosa and Acinetobacter baumannii bacterial isolates Imipenem non-susceptibility was defined as an MIC of ≥2 µg/ml. Detection of KPC and MBL-producing isolates was performed using the disk potentiation test (DPT) method.
Results
All 147 clinical bacterial isolates demonstrated resistance to Imipenem (MIC 1 -≥16 µg/ml), with Klebsiella pneumoniae carbapenemase (KPC) detected in 26.53 % (39 out of 147) isolates and metallo-beta-lactamases (MBL) in 44.89% (66 out of 147) isolates. Carbapenem resistance was notably prevalent among older male patients of the “> 60” age group, with the ICU harboring the highest number of resistant isolates, primarily associated with Acinetobacter baumannii followed by Klebsiella pneumoniae .
Conclusion
Our findings unveiled a concerning prevalence of carbapenem resistance among clinical bacterial isolates, with notable proportions of KPC and MBL producers. The findings underscore the urgent need for effective surveillance and infection control measures to mitigate the spread of multidrug-resistant pathogens in healthcare settings.
