Detection of carbapenemase producing enterobacterales using the Modified Hodge Test from clinical isolates in Colombo South Teaching Hospital and Sri Jayewardenepura General Hospital, Sri Lanka in 2017

Abstract

Introduction: Enterobacterales is a large family of Gram-negative bacilli including many pathogens. Carbapenemase producing Enterobacterales (CPEs) have emerged as a global threat. This study was conducted to detect carbapenemase production by Enterobacterales isolates from clinical specimens and to correlate the occurrence of CPE with age, gender, and duration of hospital stay of the patients included in the study.Methods: A descriptive cross-sectional study was carried out using 120 consecutive, non-repetitive clinical isolates identified as Enterobacterales by the microbiology laboratories of Colombo South Teaching Hospital and Sri Jayewardenepura General Hospital. The demographic data of the patients was gathered and used to analyse the correlation with CPE occurrence. All isolates were identified up to species level using API 20E kits. Screening for detection of carbapenemase was carried out using meropenem, imipenem, and ertapenem disks. The Modified Hodge Test (MHT), which is one of the suggested procedures to determine carbapenemase production, was performed to identify carbapenemase producing isolates.Results: Of the120 isolates, 14 (11.7%) were resistant to at least one of the carbapenems tested. MHT detected carbapenemase production in ten (8.3%) isolates. The majority of these isolates were Klebsiella sp. (6; 60.0%). Of carbapenemase producing isolates, six were from urine specimens (60%). Eight (80.0%) of the CPE harbouring patients were males and eight (80.0%) were aged above 50 years. The mean duration of hospital stay of the patients was 7.2 days (±SD 5.65days).Conclusion: The proportion of CPE was 8.3% according to this study and emphasises the importance of conducting more studies on the prevalence of CPE in Sri Lanka.