International Journal of Health Sciences and Research

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Original Research Article

Year: 2017 | Month: November | Volume: 7 | Issue: 11 | Pages: 47-55

Carbapenem Resistant Mechanism in Carbapenem Resistant Gram Negative Bacilli Other Than Carbapenemase

Sibin P S1, Anuranjini C2, Jeeva Rani3

1Microbiologist, Department of Medical Microbiology, VPS Lake Shore Hospital and Research Centre, Ernankulam, Cochin, Kerala.
2Assistant Professor, Department of Medical Microbiology, School of Health Sciences, Kannur University, Kerala.
3Microbiologist, Department of Medical Microbiology, Aster Malabar Institute of Medical Sciences, Calicut, Kerala.

Corresponding Author: Sibin P S


Introduction - Infections have been the major cause of disease throughout the history of human population. In the middle of the nineteenth century antibiotics are discovered as a powerful weapon in the battle against infectious diseases. Antibiotic resistance has been detected in many bacterial species. As each new class of antibiotic introduced into the clinical use, resistance starts to develop in the microorganism they are intended to kill. Both innate and acquired mechanisms contribute to the development of antibiotic resistance in bacteria.
Objectives - The present study was conducted to analyze the prevalence of Carbapenem resistance in gram negative bacilli and their carbapenem resistance mechanisms other than carbapenemase in tertiary care hospital.
Methods - The objectives of this study includes to analyze the carbapenemase producers and non carbapenemase producers by Modified Hodge Test ( MHT ) and to detect the presence of Efflux pump mechanism in MHT positive and negative strains by Ethidium Bromide (EtBR) agar cartwheel method.
Result - Klebsiella was found to be predominant form of carbapenem resistant gram negative bacilli. Among the 144 MHT negative strains all the strains showed either Efflux pump or Impermeability mechanisms. By Ethidium Bromide agar Cartwheel method only 10% strains were positive for efflux activity. Current study also indicates that the carbapenem resistant Pseudomonas was mainly due to Efflux activity. But in the case of carbapenem resistant Klebsiella was mainly due to impermeability mechanism. The overall prevalence of carbapenem resistant Gram Negative Bacilli was found to be 10%.

Key words: Carbapenem resistance, Modified Hodge Test, Efflux pump, Gram Negative Bacilli, Klebsiella.

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