Carbapenem Resistance in Non-Fermentative Gram-Negative Bacilli Isolated from Intensive Care Unit Patients of a Referral Hospital

  • Santosh Kumar Yadav Department of Microbiology, Rajarshi Janak University, Janakpurdham, Nepal https://orcid.org/0000-0002-1392-155X
  • Rajshree Bhujel Department of Clinical Microbiology, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal, https://orcid.org/0000-0003-2510-7966
  • Shyam Kumar Mishra School of Optometry and Vision Science, University of New South Wales, Australia https://orcid.org/0000-0002-3888-7319
  • Sangita Sharma Department of Clinical Microbiology, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal,
  • Jeevan Bahadur Sherchand Department of Clinical Microbiology, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal,
DOI: https://doi.org/10.33314/jnhrc.v19i1.3240

Abstract

Background: Non-fermentative Gram-negative bacilli or non-fermenters are opportunistic pathogens associated with serious infections in intensive care unit patients. Although carbapenems were considered as a backbone of treatment for life-threatening infections, these bacteria are increasingly acquiring resistance to carbapenems. Carbapenem-resistant Acinetobacter baumannii and Pseudomonas aeruginosa are prioritized as critical pathogens by the World Health Organization. The objective of the study was to document the status of carbapenem-resistant and carbapenemase-producing non-fermenters isolated from intensive care unit patients.
Methods: This study was conducted at Tribhuvan University Teaching Hospital, Kathmandu, Nepal. The clinical specimens collected from intensive care unit patients were processed for isolation and identification of non-fermenters and antibiotic susceptibility profile of bacterial isolates was determined. The multidrug-resistant isolates were identified and carbapenemase enzyme was detected in the carbapenem-resistant isolates.
Results: A total of 157 non-fermenters were isolated from 1063 samples which included Acinetobacter species (n=85), Pseudomonas aeruginosa (n=55), Burkholderia cepacia complex (n=15), and Stenotrophomonas maltophilia (n=2). Carbapenem resistance was reported in 85.9%, 72.7%, and 33.3% of Acinetobacter species, Pseudomonas aeruginosa, and Burkholderia cepacia complex, respectively. Among total non-fermenters, 91.1% isolates were multidrug-resistant and 60.8% carbapenem-resistant isolates were carbapenemase producers. The carbapenem-resistant isolates demonstrated an extremely high degree of resistance than carbapenem-susceptible isolates towards other antimicrobial classes.
Conclusions: This study reported high rates of carbapenem-resistant, carbapenemase-producing, and multidrug-resistant non-fermenters isolates. Therefore, preventing the spread of these superbugs among the critically ill patients in intensive care units should be a major initiative in hospitals.
Keywords: Carbapenem-resistant; carbapenemase; intensive care unit; non-fermentative Gram-negative bacilli

Published
2021-04-23
How to Cite
YadavS. K., BhujelR., MishraS. K., SharmaS., & SherchandJ. B. (2021). Carbapenem Resistance in Non-Fermentative Gram-Negative Bacilli Isolated from Intensive Care Unit Patients of a Referral Hospital. Journal of Nepal Health Research Council, 19(1), 55-61. https://doi.org/10.33314/jnhrc.v19i1.3240
Issue
Vol. 19 No. 1 (2021): Vol. 19 No. 1 Issue 50 Jan-Mar 2021
Section
Original Article

Copyright (c) 2021 Santosh Kumar Yadav, Rajshree Bhujel, Shyam Kumar Mishra, Sangita Sharma, Jeevan Bahadur Sherchand

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