Phenotypic detection of carbapenem-resistant Gram-negative bacteria from different clinical samples in a tertiary care hospital

Abstract

Carbapenem-resistant gram-negative bacteria have emerged as a significant threat, contributing to both community-acquired and healthcare-associated infections that pose a serious risk to public health. This study was conducted to assess the prevalence and impact of carbapenem-resistant gram-negative bacteria isolated from clinical specimens at Hawassa University Comprehensive Specialised Hospital. By examining these pathogens, the research aims to shed light on the extent of this resistance within the hospital environment, highlighting the challenges posed by these formidable microorganisms in the fight against infectious diseases.

Methods: A total of 2,890 clinical samples were processed, yielding 1,293 instances of Gram-negative bacilli growth. From these, 220 carbapenem-resistant strains were isolated and identified across diverse clinical specimens, including blood, urine, pus, endotracheal secretions, cerebrospinal fluid, body fluids, stool, and sputum. Of the 1293 GNB, 220 organisms exhibited resistance to carbapenem antibiotics, including imipenem and meropenem, as determined by the disc diffusion.

Results: Among 220 CRE, the most predominant organism was Klebsiella spp. with 118 isolates (53.7%), followed by Escherichia coli, with 35(15.9%), Acinetobacter spp., with 28(12.7%), Pseudomonas aeruginosa with 26 isolates (11.8%) and Enterobacter spp., 13(5.9%)

Conclusion: carbapenemase-producing Carbapenem-resistant Enterobacteriaceae (CP-CRE) spread easily in communities and cause significant morbidity and mortality. Early detection is vital in low-resource countries like India, where these carbapenemase producers are prevalent. Timely identification can improve treatment plans and infection control policies, preventing further community spread and shifting the paradigm of carbapenem resistance.