Prevalence of carbapenem-resistant isolates from clinical samples in a tertiary care hospital Vadodara, Gujarat
DOI:
https://doi.org/10.18203/2320-6012.ijrms20262178Keywords:
Carbapenem-resistant, Enterobacteriaceae and non lactose fermenter, OXA and NDMAbstract
Background: Carbapenem resistance in Gram-negative bacilli is a major concern due to the increasing antibiotic resistance, treating infections caused by Enterobacteriaceae has become more challenging. Objective was to investigate the prevalence of blaNDM, blaOXA, blaKPC, blaIMP, blaVIM producing carbapenem-resistant Enterobacteriaceae and non lactose fermenter.
Methods: The prospective observational study was conducted from September 2025 to October 2025 at department of microbiology, Parul Institute of Medical Sciences and Research. Total 100 samples were identified by VITEK 2. A modified carbapenem inactivation method was performed to detect presence of carbapenemase. O.K.N.V.I resist-5 is a rapid in vitro multiplex immunoassay kit used for the phenotypic detection of blaKPC, blaOXA, blaVIM, blaIMP, blaNDM directly from bacterial colonies.
Results: A total 100 clinical samples were taken from that 60 (60%) Enterobacteriaceae and non lactose fermenter analysed by VITEK 2. Out of them 25 (41%) isolates were multidrug resistant carbapenem Enterobacteriaceae. From 25 (41%) samples 10 (40%) were urine samples, followed by 5 (20%) blood culture, 5 (20%) pus discharge, 2 (8%) drain fluid, 2 (8%) were ET, 1 (4%) CSF. Out of 25 MDR Enterobacteriaceae and non lactose fermenter 10 (40%) were Klebsiella pneumoniae isolated 4 blaNDM, 1 OXA, 5 blaNDM and blaOXA, followed by 6 (24%) E. coli isolated 1 blaNDM, 1 blaOXA, 4 blaNDM and blaOXA, 3 (12%) Pseudomonas aeruginosa isolated 1 blaVIM and 2 blaNDM, 4 (16%) Acinetobacter baumannii isolates 4 blaNDM, 1 (4%) Acinetobacter lwoffii blaVIM gene was detected.
Conclusions: Knowledge of the prevalence of genes responsible for carbapenemase in a particular region will help in antibiotic stewardship for the selection of empiric antibiotics.
References
Sriram A, Tulara NK. Prevalence and susceptibility analysis of carbapenem resistant gram negative pathogens in tertiary care Hospital, Mumbai. J Basic Clin Pharm. 2018;9:26-30.
Joshi DN, Shenoy B, Bhavana MV, Adhikary R, Shamarao S, Mahalingam A. Prevalence of carbapenem-resistant Enterobacteriaceae and the genes responsible for carbapenemase production in a tertiary care hospital in South India. Euro Mediterr J Med. 2023;12(3):462-7.
Ravikant KP, Kumar M, Roy P, Jeya M. Detection of carbapenem-resistant Enterobacteriaceae by real time PCR and assessment of hospitalization related risk factors associated with their fecal carriage: a casecontrol study. J Pure Appl Microbiol. 2022;16(2):1111-21.
Nordmann P, Cuzon G, Naas T. The real threat of Klebsiella pneumoniae carbapenemase-producing bacteria. Lancet Infect Dis. 2009;9(4):228-36.
Datta P, Gupta V, Garg S, Chander J. Phenotypic method for differentiation of carbapenemases in Enterobacteriaceae: study from north India. Indian J Pathol Microbiol. 2012;55(3):357-560.
Ravikant, Jeya M, Felix AJW. Prevalence and risk factor analysis of fecal carriage of carbapenem-resistant Enterobacteriaceae in a tertiary care hospital. J Clin Diagn Res. 2019;13(7):DC01-6.
Jaiswal SR, Gupta S, Kumar RS, Sherawat A, Rajoreya A, Dash SK, et al. Gut colonization with carbapenem-resistant Enterobacteriaceae adversely impacts the outcome in patients with hematological malignancies: results of a prospective surveillance study. Mediter J Hematol Infect Dis. 2018;10(1):e2018025.
Bezerra PAM, Castro BD, Levin AS, Baldi LL, Cury AP, Rossi F, et al. Rapid screening for carbapenemase-producing carbapenem-resistant Enterobacterales: clinical implementation of an immunochromatographic test using broth-enriched rectal swabs. Microbiol Spectr. 2025;13(9):e01313-25.
Centers for Disease Control and Prevention. CRE technical information. 2022-04-18. 2023. https://www.cdc.gov/cre/about/index.html. Accessed on 11 March 2026.
Watkins RR, Bonomo RA. Increasing prevalence of carbapenem-resistant [1] enterobacteriaceae and strategies to avert a looming crisis. Expert Rev Anti Infec Ther. 2013;11(6):543-45.
Modi CM, Singh SP, Pandya YG, Patel CP, Patel RM. Prevalence of carbapenem resistant Enterobacteriaceae in a tertiary care hospital of Gujarat, India. Blood. 2021;273:19.
Qin HF, He JK, Chen X, Jiang K, Cai XY, Wu XN, et al. Evaluation of the NG-Test Carba 5 for the clinical detection of carbapenemase-producing gram-negative bacteria. Front Med. 2025;12:1512345.
Nagvekar V, Sawant S, Amey S. Prevalence of multidrug-resistant Gram-negative bacteria cases at admission in a multispeciality hospital. J Glob Antimicrob Resist. 2020;22:457-61.
Manohar P, Shanthini T, Ayyanar R, Bozdogan B, Wilson A, Tamhankar AJ, et al. The distribution of carbapenem- and colistin-resistance in Gram-negative bacteria from the Tamil Nadu region in India. J Med Microbiol. 2017;66(7):874-83.
Hong J, Kang D, Kim D. Performance evaluation of the newly developed in vitro rapid diagnostic test for detecting OXA-48-like, KPC-, NDM-, VIM-and IMP-type carbapenemases: the RESIST-5 OKNVI multiplex lateral flow assay. Antibiotics. 2021;10(4):460.
Joshi DN, Shenoy B, Bhavana MV, Adhikary R, Shamarao S, Mahalingam A. Prevalence of carbapenem-resistant Enterobacteriaceae and the genes responsible for carbapenemase production in a tertiary care hospital in south India. EMJ. 2023;12(3):462-7.
Kolenda C, Benoit R, Carricajo A, Bonnet R, Dauwalder O, Laurent F. Evaluation of the new multiplex immunochromatographic O.K.N.V. K-SeT assay for rapid detection of OXA-48-like, KPC, NDM, and VIM carbapenemases. J Clin Microbiol. 2018;56:e01247-18.
DebBarma P, Kokkayil P, Sarfraz A, Pati BK, Thakuria B. Phenotypic characterisation and prevalence of carbapenem-resistant Enterobacterales in a tertiary care centre in Bihar India. Sci Rep. 2025;15(1):31477.
Giri S, Sen S, Lall M. Descriptive study for detection of carbapenem resistant Enterobacteriaceae by the modified carbapenem inactivation method in a tertiary care hospital of Western Maharashtra. J Evid Based Med Healthcare. 2021;8:261-6.
Song W, Park MJ, Jeong S, Shin DH, Kim JS, Kim HS, et al. Rapid Identification of OXA-48-like, KPC, NDM, and VIM carbapenemase-producing Enterobacteriaceae from culture: evaluation of the RESIST-4 O.K.N.V. multiplex lateral flow assay. Ann Lab Med. 2020;40(3):259-63.
Nagarathna SM. Detection of carbapenemase producing Enterobacteriaceae. Rajiv Gandhi University of Health Sciences (India). 2014.
Gürbüz M, Gencer G. Global trends and future directions on carbapenem-resistant Enterobacteriaceae (CRE) research: a comprehensive bibliometric analysis (2020-2024). Medicine. 2024;103(49):e40783.
Verma G, Nayak SR, Jena S, Panda SS, Pattnaik D, Praharaj AK, et al. Prevalence of carbapenem-resistant Enterobacterales, Acinetobacter baumannii, and Pseudomonas aeruginosa in a tertiary care hospital in eastern India: a pilot study. J Pure Appl Microbiol. 2023;17(4):2243-9.