Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Original article / research
Year : 2017 | Month : March | Volume : 11 | Issue : 3 | Page : DC10 - DC13

Prevalence of Carbapenem Resistant Non-Fermenting Gram Negative Bacterial Infection and Identification of Carbapenemase Producing Nfgnb Isolates by Simple Phenotypic Tests

Jane Esther, Diego Edwin, Uma

1. Postgraduate, Department of Microbiology, Chennai Medical College and Research Centre, Dr. MGR Medical University, Trichy, Tamilnadu, India. 2. Assistant Professor, Department of Microbiology, Chennai Medical College and Research Centre, Dr. MGR Medical University, Trichy, Tamilnadu, India. 3. Professor and Head, Department of Microbiology, Chennai Medical College and Research Centre, Dr. MGR Medical University, Trichy, Tamilnadu, India.

Correspondence Address :
Dr. Jane Esther,
C4, 10 B Cross Thillai Nagar, Trichy-620018, Tamilnadu, India.
E-mail: janesweety16@gmail.com

Abstract

Introduction: Non-Fermenting Gram negative bacilli (NFGNB) are emerging multi-drug resistant pathogens causing nosocomial infections. In recent years, carbapenem resistance in NFGNB has increased due to a variety of drug resistance mechanisms, the most common being production of carbapenemases.

Aim: To detect carbapenemase and metallo-b-lactamase (MBL) production in NFGNBs by four phenotypic tests and to compare the various phenotypic methods for detection of carbapenemase and MBL production in nosocomial NFGNB isolates.

Materials and Methods: It is a cross sectional study carried out in the department of Microbiology, Chennai Medical College Hospital and Research Center, Irungalur, Trichy between January 2015 and December 2015. Out of the 598 NFGNB isolated from all the 5402 heterogenous clinical samples that were processed, 52 (8.7%) NFGNB showed resistance or intermediate sensitivity to meropenem as tested by disc diffusion assay. All the 52 isolates were subjected to four different phenotypic tests for carbapenemase and MBL detection, which included Modified Hodge Test (MHT), Meropenem-EDTA Disc Synergy (EDS) test, Meropenem-EDTA Combined Disc Test (CDT) and Growth on CHROMagar KPC.

Results: Among the 52 isolates, 29 (55.77%) were MHT positive and 49 (94.23%) were positive for growth on CHROMEagar KPC which were identified as carbapenemase producers. 44 (84.61%) were EDS positive and 46 (88.46%) were CDT positive which were identified as metallo-b-lactamase producers.

Conclusion: The presence of these resistant bugs strongly suggests the need to prevent their further spread by implementation of strict infection control measures and regular surveillance to check their outcome. Growth on CHROMagar KPC is the test that has picked up more number of carbapenem resistant isolates as carbapenemase and metallo-b-lactamase producers among the four tests. It is also cheap and easy to perform, making it the most reliable test for routine screening of carbapenemase and MBL producers in clinical laboratories.

Keywords

CHROMagar KPC, Meropenem- EDTA disc synergy test, Meropenem-EDTA combined disc test, Modified-Hodge test

How to cite this article :

Jane Esther, Diego Edwin, Uma. PREVALENCE OF CARBAPENEM RESISTANT NON-FERMENTING GRAM NEGATIVE BACTERIAL INFECTION AND IDENTIFICATION OF CARBAPENEMASE PRODUCING NFGNB ISOLATES BY SIMPLE PHENOTYPIC TESTS. Journal of Clinical and Diagnostic Research [serial online] 2017 March [cited: 2017 Mar 28 ]; 11:DC10-DC13. Available from
http://www.jcdr.net/back_issues.asp?issn=0973-709x&year=2017&month=March&volume=11&issue=3&page=DC10-DC13&id=9526

DOI and Others

DOI: 10.7860/JCDR/2017/23996.9526

Date of Submission: Sep 07, 2016
Date of Peer Review: Sep 23, 2016
Date of Acceptance: Nov 21, 2016
Date of Publishing: Mar 01, 2017

Financial OR OTHER COMPETING INTERESTS: None.

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