Sanjib Adhikari1, Sujan Khadka1*, Jid Chani Rana2, Sushmita Baniya1, Susma Poudel1, Archana Chapagain1 and Ramesh Regmi1
1Department of Microbiology, Birendra Multiple Campus, Tribhuvan University, Chitwan, Nepal.
2Research Laboratory, Bharatpur Hospital, Chitwan, Nepal.
*Sujan Khadka, Email: [email protected]
Article info
Received: 01-03-2019,
Revised: 04-04-2019,
Accepted: 10-04-2019
Abstract
Carbapenems are regarded as the last drugs of choice for the treatment of the infections caused by drug-resistant bacteria. The emergence of carbapenem-resistant Enterobacteriaceae (CRE) has become a major public health concern worldwide and a new challenge in the treatment of infectious diseases. The study was conducted to determine the prevalence of CRE at a tertiary care hospital in Bharatpur Chitwan, Nepal from September 2016 to February 2017. Aseptically collected clinical specimens (urine, pus, and blood) were cultured in Mac-Conkey agar and blood agar and the Gram-negative isolates obtained were subjected to an array of biochemical tests. Antibiotic Susceptibility Test (AST) was performed against carbapenem antibiotics for Enterobacteriaceae isolates by the disc-diffusion method according to CLSI (Clinical and Laboratory Standards Institute) guidelines. Among 1720 samples, only 287 showed growth. Enterobacteriaceae isolates were recovered from 140 samples. Carbapenem resistance in Klebsiella pneumoniae (57.1%) was higher than in E. coli (41.3%). Overall prevalence of CRE was 40.7%. Among the CRE isolates, E. coli (78.9%) was more frequent than K. pneumoniae (21.0%). On phenotypic testing, the carbapenemase-producing bacteria were found to be K. pneumoniae (33.3%), Enterobacter aerogenes (33.3%) and E. coli (15.6%). Higher prevalence of carbapenem-resistant Enterobacteriaceae isolated from hospitalized and OPD-patients emphasize an urgent need for CRE control activities and rationalizing the use of antibiotics.
Keywords
Carbapenems, Carbapenem-resistant Enterobacteriaceae, Blood, Pus, Urine
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