Study of carbapenem resistance in patients admitted to MICU in a tertiary care hospital

Authors

  • Eby P. Shaji Department of Microbiology, Government Medical College, Aurangabad, Maharashtra, India
  • Jyoti A. Iravane Department of Microbiology, Government Medical College, Aurangabad, Maharashtra, India
  • Mangala S. Harbade Department of Microbiology, Government Medical College, Aurangabad, Maharashtra, India
  • Anil A. Gaikwad Department of Microbiology, Government Medical College, Aurangabad, Maharashtra, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20250967

Keywords:

Carbapenem resistance, Carbapenems, Gram negative bacilli, MICU

Abstract

Background: Carbapenem Resistance is defined as gram negative bacteria that are resistant to one or all of the following carbapenems: ertapenem, meropenem, imipenem or doripenem. Recognizing the risk of resistance to carbapenem especially in the most vulnerable patients and the early detection of specific carbapenem-resistance mechanisms are critical to reducing the risk of mortality, length of hospitalization and associated costs. So, this study is done to detect carbapenem resistance in patients admitted in MICU.

Methods: A Retrospective study was carried out for one year from period of January 2023-January 2024 in the Department of Microbiology, Government Medical College, Aurangabad. Total 1941 samples were received from patients admitted in the medical intensive care unit (MICU). The isolates were identified using standard microbiological methods. Antimicrobial susceptibility was performed using the Kirby-Bauer disc diffusion technique and interpreted as per CLSI 2023 standards.

Results: Out of 1941 samples, total gram-negative isolates were 775 (40%), 478 samples were sterile and rest were gram positive organism. Out of gram-negative organism Acinetobacter baumannii (26.58%), Escherichia coli (11.74%), Klebsiella pneumoniae (32.25%) and Pseudomonas aeruginosa (29.41%) were isolated. In case of Acinetobacter, Carbapenem resistant is high and is around 90%, in Escherichia coli it is 74%, in Klebsiella and Pseudomonas it is 83% and 44% respectively.

Conclusions: In our study Acinetobacter baumannii shows high carbapenem resistance. The efficient ways to avoid infection include strict adherence to infection prevention and control practices like hand hygiene techniques and bundle care approach.

Metrics

Metrics Loading ...

References

Yi J, Kim KH. Identification and infection control of carbapenem-resistant Enterobacterales in intensive care units. Acute Crit Care. 2021;36(3):175-84. DOI: https://doi.org/10.4266/acc.2021.00409

Elshamy AA, Aboshanab KM. A review on bacterial resistance to carbapenems: epidemiology, detection and treatment options. Future Sci OA. 2020;27;6(3):438. DOI: https://doi.org/10.2144/fsoa-2019-0098

Verma S, Thorat SS, Bisure K. Prevalence of carbapenem resistant Enterobacteriaceae-a study in a tertiary care hospital in Mumbai. Blood. 2018;3(25):12.

Pawar SK, Mohite ST, Shinde RV, Patil SR, Karande GS. Carbapenem resistant Enterobacteriaceae: Prevalence and bacteriological profile in a tertiary teaching hospital from rural western India. Indian J Microbiol Res. 2018;5(3):342-7. DOI: https://doi.org/10.18231/2394-5478.2018.0072

Porwal R, Gopalakrishnan R, Rajesh NJ, Ramasubramanian V. Carbapenem resistant Gram-negative bacteremia in an Indian intensive care unit: A review of the clinical profile and treatment outcome of 50 patients. Indian J Crit Care Med. 2014;18(11):750-3. DOI: https://doi.org/10.4103/0972-5229.144021

Tempe DK, Agarwal J, Chaudhary K. Carbapenem resistance patterns in general intensive care unit of a tertiary care hospital in India. MAMC J Med Sci. 2015;1(2):85-91. DOI: https://doi.org/10.4103/2394-7438.157918

Sharma K, Tak V, Nag VL, Bhatia PK, Kothari N. An observational study on carbapenem-resistant Enterobacterales (CRE) colonisation and subsequent risk of infection in an adult intensive care unit (ICU) at a tertiary care hospital in India. Infect Prev Pract. 2023;30;5(4):100312. DOI: https://doi.org/10.1016/j.infpip.2023.100312

International Journal of Basic and Applied Medical Sciences An Open Access, Online International Journal Available at: http://www.cibtech.org/jms. Accessed on 18 January 2025.

Alizadeh N, Ahangarzadeh Rezaee M, Samadi Kafil H, Hasani A, Soroush Barhaghi MH, Milani M, et al. Evaluation of Resistance Mechanisms in Carbapenem-Resistant Enterobacteriaceae. Infect Drug Resist. 2020;13:1377-85. DOI: https://doi.org/10.2147/IDR.S244357

Elbadawi HS, Elhag KM, Mahgoub E, Altayb HN, Ntoumi F, Elton L, et al. Detection and characterization of carbapenem resistant Gram-negative bacilli isolates recovered from hospitalized patients at Soba University Hospital, Sudan. BMC Microbiol. 2021;4(1):136. DOI: https://doi.org/10.1186/s12866-021-02133-1

Shanmugapriya S, Appalaraju B, Karim MA, Rizwana MM. Screening of Intensive Care Unit Patients for the Presence of Carbapenem-resistant Enterobacterales (CRE) on Admission as a Measure of Infection Control. J Pure Appl Microbiol. 2024;18(3):1721-8. DOI: https://doi.org/10.22207/JPAM.18.3.21

Apisarnthanarak A. The role of infection control in curbing Carbapenem resistance, Int J Infect Dis. 2012;16:27-8. DOI: https://doi.org/10.1016/j.ijid.2012.05.072

Esther J, Edwin D. Prevalence of Carbapenem Resistant Non-Fermenting Gram Negative Bacterial Infection and Identification of Carbapenemase Producing NFGNB Isolates by Simple Phenotypic Tests. J Clin Diagn Res. 2017;11(3):10-3. DOI: https://doi.org/10.7860/JCDR/2017/23996.9526

Das NK, Grover R. Prevalence of carbapenem resistance and comparison between different phenotypic methods for detection of metallo-β-lactamases in gram negative non-fermentative bacteria in the acute wards of a tertiary care centre. Int J Curr Microbiol App Sci. 2016;5(5):109-19. DOI: https://doi.org/10.20546/ijcmas.2016.505.012

Downloads

Published

2025-03-29

How to Cite

Shaji, E. P., Iravane, J. A., Harbade, M. S., & Gaikwad, A. A. (2025). Study of carbapenem resistance in patients admitted to MICU in a tertiary care hospital. International Journal of Research in Medical Sciences, 13(4), 1472–1476. https://doi.org/10.18203/2320-6012.ijrms20250967

Issue

Section

Original Research Articles