Menace to the ultimate antimicrobials among commonEnterobacteriaceaeclinical isolates in part of North-East India

Abstract

AbstractIntroductionEnterobacteriaceae, the normal dwellers in the human intestine, commonly associated with a variety of community acquired and nosocomial infections. Emerging trend of antibiotic resistance among these strains is a notable issue globally; more serious threat is the resistance against the available last resort antibiotics- the carbapenems. Our study thus intended to determine the burden of resistance towards this ultimate antimicrobial class, so as to assist in the empiric therapeutic decision making process and to search for alternate options.Materials and MethodsOur study was a cross-sectional study with inclusion of clinical isolates collected from varied sources, from health settings in upper Assam. The isolates were identified based on standard methods of morphology study and biochemical tests. The identified isolates were then subjected to antibiotic susceptibility testing following Kirby-Bauer disc diffusion method and the result interpreted as per the CLSI guidelines. The resistance of the reported carbapenem resistant isolates was confirmed by minimum inhibitory concentration (MIC) determination using commercial E-strip kit.ResultsAmong the enterobacterial isolatesKlebsiellaspp. accounted the majority, followed byEscherichia coli,Citrobacterspp.,Shigellaspp. and others. Multi-drug resistance (MDR) was noted among 67.6% isolates; however, carbapenem resistance was confirmed in 18.9% of the totalEnterobacteriaceaeisolates.ConclusionHigher prevalence of resistance towards the last resort antimicrobial, carbapenems, among theEnterbacteriaceaeisolates of upper Assam seems to be upcoming threat to the region, limiting the treatment options in future.