Antibiotic Resistance Pattern of Multi-drug Resistant Klebsiella pneumoniae and Detection of Carbapenem-resistance Genes

Background: Resistance to carbapenem is increasing over the years, which comes as one of the therapy of last resort therapy for critically ill patients. The current scenario is such that the antibiotics in hand are few for carbapenem-resistant Klebsiella pneumoniae and has created a major problem in our setup. Aim and Objectives: Our study highlights the detection of antibiotic resistance pattern of Multidrug Resistant (MDR) Klebsiella pneumoniae, carbapenemase genes involved and Minimum Inhibitory Concentration (MIC) of Meropenem and Colistin in MDR Klebsiella pneumoniae. Material and Methods: A total of 51 MDR Klebsiella pneumoniae were obtained from various clinical samples over 6 months from patients admitted to two tertiary care hospitals. MIC for Meropenem and Colistin by microbroth dilution and Xpert Carba R assay for carbapenemase genes detection was done for MDR Klebsiella pneumoniae. Results: In our setup,45 (88.2%) MDR Klebsiella pneumoniae were resistant to three or more classes of antimicrobial agents. Among the carbapenem-resistant strains, New Delhi metallobetalactamases-1 (NDM-1), Oxacillinase-48 (OXA-48) and both were detected in 17, 7 and 5 patients respectively. Conclusion: NDM-1 was the most frequently associated gene with carbapenem resistance. Infections with MDR Klebsiella are a therapeutic challenge for clinicians. Combination therapy, double carbapenem therapy, beta-lactam inhibitor combination like ceftazidime avibactum, are the only few options that become available for clinicians, especially when OXA-48 genes are detected.