Phenotypic and genotypic detection of carbapenemase production among gram negative bacteria isolated from hospital acquired infections

Phenotypic and genotypic detection of carbapenemase production among gram negative bacteria isolated from hospital acquired infections

To identify the carbapenemase producing Gram-negative bacteria (GNB) by phenotypic methods and to confirm the presence of resistant genes using real-time polymerase chain reaction (PCR). This was a prospective study carried out at the Department of Microbiology, Sri Venkata Sai Medical College and H...

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Bibliographic Details
Published in:Saudi medical journal Vol. 43; no. 3; pp. 236 - 243
Main Authors: Vamsi, Sreeja K, Moorthy, Rama S, Hemiliamma, Mary N, Chandra Reddy, Rama B, Chanderakant, Deepak J, Sirikonda, Shravani
Format: Journal Article
Language:English
Published: Saudi Arabia Saudi Medical Journal 01-03-2022
Prince Sultan Military Medical City (PSMMC)
Subjects:
Anti-Bacterial Agents - pharmacology
Antibiotics
Bacterial Proteins - genetics
Beta lactamases
beta-Lactamases - genetics
Causes of
Cross infection
Drug resistance in microorganisms
Genes
Genetic aspects
Genotype & phenotype
Gram-negative bacteria
Gram-Negative Bacteria - genetics
Health aspects
Hospitals
Humans
Identification and classification
Immune system
Microbial Sensitivity Tests
Nosocomial infections
Original
Penicillin
Prospective Studies
India
beta-lactamases
carbapenems
drug resistance
microbial
antibacterial agents
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Summary:To identify the carbapenemase producing Gram-negative bacteria (GNB) by phenotypic methods and to confirm the presence of resistant genes using real-time polymerase chain reaction (PCR). This was a prospective study carried out at the Department of Microbiology, Sri Venkata Sai Medical College and Hospital, Mahabubnagar, India, from March 2018-2021. All samples were screened for carbapenem resistance by disc diffusion method and the VITEK 2 compact system (bioMérieux, France). Detection of carbapenemase was carried out using RAPIDEC CARBA NP test (Biomeriux Private Limited, South Delhi, India), screening for metallo-β-lactamases (MBL) was carried out by double disk synergy test (DDST), and genotypic characterization by real-time PCR. Among the 1093 Gram-negative bacilli identified, 220 (17.0%) were resistant to carbapenems by both tested methods. Carbapenemase detection using the RAPIDEC CARBA NP test indicated that 207 (94.0%) were carbapenemase producers, of which 189 (91.2%) were MBL producers. The most common carbapenemase genes identified were New Delhi metallo-β-lactamase (NDM; 47.3%), followed by the co-existence of genes in combination of NDM, with Verona integron-mediated metallo-β-lactamase (VIM; 39.6%), VIM and oxacillin hydrolyzing enzymes-48 (OXA-48; 4.3%), and OXA-48 (1.4%).No gene of active on imipenem, carbapenemase, VIM, or OXA-48 alone was detected. This study suggests routine carbapenem resistance testing among multi-drug resistant-GNBs, as most of these infections occur in hospitals. In addition, there is a possibility that these highly antibiotic-resistant genes could spread to other bacteria resulting in further dissemination.
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ISSN:0379-5284
1658-3175
DOI:10.15537/smj.2022.43.3.20210809