CARBAPENEM RESISTANT KLEBSIELLA PNEUMONIAE IN A TERTIARY CARE HOSPITAL IN NORTHERN INDIA

Background:-Antibiotic resistance is a global public health problem. The foundation of modern medicine is built on the availability of effective antibiotics, especially in economically deprived areas of the world. Identi?cation of carbapenem-resistant Klebisella pneumoniae infection may assist in the empiric therapeutic decision-making process and allow for early implementation of appropriate infection-control measures. Aims & objectives:- To find out the prevalence of Klebsiella pneumoniae strains resistant to carbapenems, to ascertain antibiogram of strains and formulate an advisory for control and treatment of infections. Material & Methods:-The study was conducted in the department of Microbiology, SKIMS, Soura, Srinagar (J&K). Patients attending the OPD or admitted during one year were taken for the study. Different samples were processed according to the standard microbiological techniques. Antimicrobial sensitivity of Klebsiella isolates was performed according to CLSI guidelines. The minimum inhibitory concentration of imipenem for isolates that were resistant to imipenem was done by microbroth dilution method. Results:- Overall prevalence of Carbapenem resistant Klebsiella pneumonia was 27.9%. Majority (84.2%) of the imipenem resistant Klebsiella isolates were found to be carbapenemase producers. The predominant source of both imipenem resistant and Modified Hodge test positive isolates were urine, pus and blood. The recovery of Klebsiella isolates from urine and blood was found to be statistically significant (p<0.05). Maximum numbers of carbapenem resistant isolates were recovered from patients with sepsis (15.78%). Antibiogram showed a high degree of resistance to cephalosporins (>90%) with maximum sensitivity to tigecycline and polymyxin B (100%). Conclusion:- Carbapenem resistant Klebsiella is a major problem in our hospital. Early detection of carbapenemase producing Klebsiella spp. may avoid future spread of these isolates and ensure better patient care and timely introduction of appropriate infection control measures.