Metallo - β - Lactamase Producers among Carbapenem Resistant Gram-Negative Isolates from Clinical Samples in a Tertiary Care Hospital

Abstract

Gram – Negative Bacilli (GNB) are important cause of UTI, Blood stream infections, hospital acquired pneumonias. With the Carbapenems becoming the drug of choice in treating Multidrug resistant Organisms (MDRO) due to their safety and efficacy, there is rise in Carbapenem Resistant organisms which is becoming a threat to health care setup. Early diagnosis of Metallo – β – lactamase (MBL) producers by routine laboratory methods makes it the need of the hour to prevent spread of resistant strains. To detect MBL producers among Carbapenem resistant GNB. GNB were isolated from 2576 various clinical samples received by Department of Microbiology between December 2020 to March 2021. MBL production among Carbapenem resistant GNB was tested by Combined Disc Diffusion Assay using Imipenem disc and Imipenem + EDTA disc. Results: 899 GNB were isolated among 2576 samples with E. coli (35.05%) followed by Klebsiella species (28.58%) and Pseudomonas aeruginosa (14.90%). 180 isolates (20.02%) were Carbapenem Resistant GNB of which 55 isolates (30.55%) were MBL producers with Klebsiella species (29.01%) being highest MBL producer followed by Pseudomonas aeruginosa (27.27%). Rapid dissemination of MBL producers is worrisome making routine detection of MBL strains important. Regular surveillance, strict adherence to infection control measures and implementation of proper antibiotic policy is crucial to minimize the increasing Carbapenem resistance.