Phenotypic detection of carbapenem resistant Enterobacteriaceae and characterization of Klebsiella pneumoniae carbapenemase (KPC) producing Klebsiella pneumoniae

Abstract

Background: Carbapenem-resistant Enterobacteriaceae (CRE) pose a great threat to the public health sector as a result of its high communicability, high morbidity and mortality rates. This study investigated the occurrence of carbapenem resistant Enterobacteriaceae and the prevalence of Klebsiella pneumoniae carbapenemase (KPC) producing Klebsiella pneumoniae as a mechanism of resistance.

Method: One hundred and ten Enterobacteriaceae isolates were cultured from different samples of patients in Intensive Care Units of two hospitals. Using Clinical and Laboratory Standards Institute (CLSI) Guidelines of 2017. Carbapenemase production was determined phenotypically using Brilliance CRE agar, Carbapenem inactivation method and confirmed with Modified Hodge test (MHT). Modified Hodge test positive isolates were screened for KPC-producing Klebsiella pneumoniae using boronic acid-based inhibition test.

Result: Phenotypic results revealed an occurrence of 10.9% (12/110) isolates for carbapenem resistant Enterobacteriaceae while KPC-producing Klebsiella pneumoniae prevalence was 3.6% contributing 33.3% to the burden of carbapenem production. The occurrence of carbapenem-resistant Enterobacteriaceae in this study was relatively high and KPC- Klebsiella pneumoniae had a significant contribution to the burden of CRE.

Conclusion: Hence, a sinewy antibiotic stewardship is needed in this regard.