Higher Rate of Extreme Drug-resistant Klebsiella pneumoniae Infections among Cardiac Patients

  • Subash Paudel Department of Microbiology, Tri-Chandra Multiple Campus, Ghantaghar, Kathmandu
  • Pradeep Kumar Shah Department of Microbiology, Tri-Chandra Multiple Campus, Ghantaghar, Kathmandu
  • Prashanna Adhikari Department of Microbiology, Tri-Chandra Multiple Campus, Ghantaghar, Kathmandu
  • Sanjay Singh K. C. Department of Pathology, Sahid Gangalal National Heart Center, Bansbari, Kathmandu
  • Upendra Thapa Shrestha Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu
DOI: https://doi.org/10.33314/jnhrc.v19i04.3524

Abstract

Background: The accelerating rate of carbapenems resistance in Klebseilla pneumoniae isolates has put the treatment option worrisome. The effective strategy to ameliorate this alarming situation is possible through enhancing the combination therapy and appropriate laboratory diagnosis. Hence, the study was focused on identifying carbapenemase-producing K. pneumoniae and their antibiogram pattern.
Methods: A total of 944 clinical samples from patients attending Sahid Gangalal National Heart Center were processed from September 2019 to March 2020 to identify the possible bacterial pathogens following the standard microbiological procedures. K. pneumonaie isolates were further subjected to antibiotic susceptibility testing by the modified Kirby Bauer disc diffusion technique. Phenotypic confirmation of carbapenemase production was done by the modified carbapenemase inactivation method. The minimum inhibitory concentration of colistin was determined by the broth microdilution method.
Results: Of the total 944 samples, 15.47% (146) samples showed bacterial growth, among which 23.97% (35) were K. pneumoniae. Out of 35 K. pneumoniae isolates, 45.71% (16) were multidrug-resistant followed by 42.86% (15) extensively drug-resistant. Fourteen isolates of K. pneumoniae were carbapenemase producers among which 20% (7) were serine carbapenemase while 20% (7) showed metallo-?-lactamase production. All the carbapenemase-producing K. pneumoniae were susceptible to colistin with <0.125µg/ml. Carbapenemase activity showed statistically significant with multidrug resistance (p=<0.05).
Conclusions: An increasing resistance to the carbapenem drugs showed a great problem in the management of K. pneumoniae infections among immunocompromised patients especially cardiac patients however, colistin can be still an ultimate choice of drug for disease management.
Keywords: Broth microdilution; carbapenemase; colistin; extreme drug-resistant; klebsiella pneumonia.

Published
2022-03-13
How to Cite
PaudelS., ShahP. K., AdhikariP., Singh K. C.S., & Thapa ShresthaU. (2022). Higher Rate of Extreme Drug-resistant Klebsiella pneumoniae Infections among Cardiac Patients. Journal of Nepal Health Research Council, 19(04), 661-668. https://doi.org/10.33314/jnhrc.v19i04.3524
Issue
Vol. 19 No. 04 (2021): Vol 19 No 4 Issue 53 Oct-Dec 2021
Section
Original Article

Copyright (c) 2022 Subash Paudel, Pradeep Kumar Shah, Prashanna Adhikari, Sanjay Singh K. C., Upendra Thapa Shrestha

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