Prevalence of Carbapenem-Resistant Hospital Acquired Infections and Their Antimicrobial Susceptibility Pattern in a Tertiary Care Hospital

Background: The emergence of antimicrobial-resistant bacteria has become a public threat, creating a burden on medical care in hospitals. Carbapenem-resistant organisms are a source of both community-acquired and healthcare-acquired infection that poses a substantial hazard to public health. This study aimed to conclude the prevalence of carbapenem resistance gram-negative bacteria from a clinical specimen at Index Medical College -Indore.

Methodology: This study was conducted in the Department of Microbiology, at Index Medical College, Indore, between January 2020 and January 2022.The isolates were subjected to antimicrobial susceptibility tests by Kirby Bauer’s disk diffusion test. Most of the isolates were resistant to beta-lactam drugs, cephalosporin’s and aminoglycosides. These isolates were further confirmedby phenotypic detection usingthe Modified Hodge test, Modified carbapenem Inactivation, Combined disc diffusion test and Double Disk Synergy.

Results: The percentage distribution of health-associated infection show highest resistance in both urinary tract and respiratory tract infection, followed by skin & soft tissue infection and least in septicemia and other health associated infection. Highest percentage of resistance was seen in the age group between 21-30 and the least in less than 10 years with a statistical significance of p-value=.00001. The most common isolates recover was E.coli in Enterobacterals and in Non fermenter it was Pseudomonas aeruginosa and Acientobacter. The sensitivity of MHT, mCIM, CDDT, and DDST within CI 95% were 74%, 95%, 84%, and 95% respectively. The overall prevalence of carbapenem resistance is 17.75%.

Conclusion: The production of carbapenemase is the major mechanism underlying carbapenem resistance around the world and represents a great health concern. More knowledge is needed to control resistant genes and resistant organisms and their dissemination. There is an urgent need for global collaboration to plan valid strategies to prevent the spread of carbapenemase and the development of new antimicrobial molecules.