Characterizing carbapenemase production in Enterobacterales through combined disk test and genetic profiling

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Original Article

Author Details : Shuchita Gaur*, Rupam Gahlot, Nikita Sherwani, Suchita Netam, Sneha Dadarya

Volume : 11, Issue : 2, Year : 2024

Article Page : 97-102

https://doi.org/10.18231/j.ijmr.2024.018

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Abstract

Background: Carbapenem-resistant Enterobacterales (CRE) are major organisms amongst the critical group of drug-resistant bacteria and are associated with high morbidity and mortality. With limited treatment options, the detection and characterization of carbapenemase is important for appropriate management. This study aims to characterize carbapenemase produced by Enterobacterales using combined disk test and their molecular profiling.
Materials and Methods: All carbapenem-resistant Enterobacterales isolated from various clinical samples were included in the study. Carbapenemase production was characterized by observing synergy on combining meropenem disk with beta-lactamase inhibitors like phenylboronic acid, EDTA, and cloxacillin, following which genetic profiling was done using multiplex PCR.
Results: Out of 445 Enterobacterales isolated, 104 (23.4%) were carbapenem-resistant. The most common CRE isolated was Klebsiella pneumoniae (62 out of 104) followed by Escherichia coli (40 out of 104) and 2 out of 104 CRE isolates were Enterobacter species. Co-production of NDM and OXA-48-like enzymes (39.4%) was the most common mechanism followed by NDM alone (19.2%) and OXA-48 alone (16.3%). NDM was the most common gene detected overall with 72 out of 104 CRE (69.2%) isolates showing its presence, followed by OXA-48 present in 63 of 104 (60.6%) isolates.
Conclusion: Metallo-beta-lactamases (NDM) was the predominant type of carbapenemase gene detected among the isolates, with the co-production of NDM and OXA-48 enzymes being the most common mechanism of resistance.
 

Keywords: Carbapenemase, Carbapenem-resistant Enterobacterales, Carbapenem production, Antimicrobial resistance, Multi- drug resistant organisms.

How to cite : Gaur S, Gahlot R, Sherwani N, Netam S, Dadarya S, Characterizing carbapenemase production in Enterobacterales through combined disk test and genetic profiling. Indian J Microbiol Res 2024;11(2):97-102

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