CARBAPENEM RESISTANT GRAM NEGATIVE ISOLATES FROM BURN WOUND INFECTION IN A TERTIARY CARE CENTRE.

Carbapenems are beta lactam antibiotics with the broadest spectrum of activity used for the treatment of infections caused by multi drug resistant (MDR) strains of gram negative bacteria especially in hospitalized people. Carbopenems are often considered as the last line of therapy. During the last few years, carbapenem resistance has been increasingly reported among the group of Enterobacteriance and nonfermenters. This may be attributed to the production of carbopinemases / metallo-beta-lactamases (MBLs). Most often carbopenem resistant bacteria have been reported from urinary infection, septicaemia wound infection and pneumonia. The present study shows the high prevalence rate of such strains (67.92%) among the isolates obtained from burn wound infection at Govt. Medical College, Thiruvananthapuram. A total no. of 22 patients were admitted following blast injury at Puttigal, a village at Kollam District on 10-04-2016 Kerala, from whom 56 samples of exudates and 10 samples of blood were collected from third day of admission. The age group of the patients being 16 yrs to 70 yrs and the extent of bruns ranging from 20% to 70%. Majority of the bacterial isolates obtained in culture from exudates and blood were multidrug resistant (75%). The predominant species was pseudomonas aeruginosa (39.58%) carbapenemase production wasdetected by phenotypic screening methods such as Imepenem resistance by disc diffusion technique by Kirby ? Bauer Method, combined disc test, modified Hosge test and E-test. Of the total no. of 53 multidrug resistant gram negative isolates obtained in the study, 100% of E.coli, 71.43% of pseudomonas aeruginosa, 70.59% ofAcinetobacterbaumanii and 53.85% of klebsiellapneumoniae, were carbapenemase producers. All the strains were susceptible to Colistin and polymyxins. The high prevalence of carbapenemase resistant strains highlights the need for active approach by both clinician and microbiologist to initiate infection control measures to prevent their dissemination.