PREVALENCE OF CARBAPENAM RESISTANT KLEBSIELLA PNEUMONIAE IN A TERTIARY CARE HOSPITAL, HYDERABAD, TELANGANA STATE

S.K. TIPPARTHI¹, S. AKULA²*, G. MANDERWAD³, H.R.V. RAJKUMAR^4
1Department of Microbiology, Kamineni Academy of Medical Sciences and Research Centre, Hyderabad, 500068, Kaloji Narayana Rao University of Health Sciences, Warangal, 506007, Telangana, India
²Department of Microbiology, Gandhi Medical College, Secunderabad, 500003, Kaloji Narayana Rao University of Health Sciences, Warangal, 506007, Telangana, India
³Department of Microbiology, Kamineni Academy of Medical Sciences and Research Centre, Hyderabad, 500068, Kaloji Narayana Rao University of Health Sciences, Warangal, 506007, Telangana, India
⁴Department of Microbiology, Kamineni Academy of Medical Sciences and Research Centre, Hyderabad, 500068, Kaloji Narayana Rao University of Health Sciences, Warangal, 506007, Telangana, India
* Corresponding Author : drswathi.gurajala@gmail.com

Received : 10-08-2019     Accepted : 26-08-2019     Published : 30-08-2019
Volume : 11     Issue : 8       Pages : 1694 - 1696
Int J Microbiol Res 11.8 (2019):1694-1696

Keywords : Carbapenemases, carbapenam resistant Klebsiella pneumoniae, Klebsiella pneumonia, Antimicrobial susceptibility testing, Infection control, Multiplex PCR
Academic Editor : Dr Ranjana Hawaldar
Conflict of Interest : None declared
Acknowledgements/Funding : Authors are thankful to Department of Microbiology, Kamineni Academy of Medical Sciences and Research Centre, Hyderabad, 500068, Telangana, India
Author Contribution : All authors equally contributed

Background: Irrational and indiscriminate use of Carbapenam antibiotics has resulted in emergence of extremely drug resistant bugs. The carbapenam resistance among the Enterobacteriaceae has increased enormously in the last decade which is of particular concern. Carbapenam resistant Klebsiella pneumoniae account for about 26-44% of the deaths. Materials and methods: The study was conducted for a period of 6 months. The specimens received were endotracheal aspirates, pus, urine, blood and sputum and were processed by standard microbiological methods. 60 isolates of Klebsiella spp from inpatient specimens which were resistant to carbapenam antibiotics were further subjected to genotypic characterization for the detection of carbapenamase enzymes. Results: The mean age of the patients was 43.7yrs. Risk factors identified were prolonged ICU stay, repeated hospitalisations, prior exposure to antibiotics and presence of indwelling catheters/tubes. The source of infection in majority of the cases was nosocomial, attributed to presence of invasive devices. The isolates were moderately susceptible to carbapenams and highly susceptible to Polymixins. Carbapenamases are detected in about 44 (73.33%) isolates. Among these, Co expression with one or more enzyme subclasses was noted in about 22 (50 %) isolates. The mortality rate was 54% in our hospital. Conclusion: This intimidating situation can be addressed by strict adherence to infection control practices in conjunction with effective use of diagnostic methods in the clinical microbiology laboratory to identify the CRKP along with education of health care providers, patients and laypersons to limit the abuse or overuse of antibiotics.

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