Carbapenem Resistance among Klebsiella pneumoniae in a Tertiary Care Hospital in Bangladesh.

Mymensingh medical journal : MMJ Pub Date : 2023-04-01
S J Sonia, K H Uddin, S M Shamsuzzaman
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Abstract

Carbapenem-resistant K pneumoniae (CRKP) clinical isolates have spread widely now-a-days throughout the world. This study was designed to investigate the carbapenem resistance among Klebsiella pneumoniae and to see anitimicrobial susceptibility of these CRKP isolates to other antimicrobials in a tertiary care hospital in Bangladesh. K pneumoniae was detected by standard methods and various biochemical tests like Triple Sugar Iron (TSI) agar media, Simmons citrate agar media and Motility-Indole-Urea (MIU) agar media. Imipenem resistance was used as the indicator for carbapenem resistance. Agar dilution method was used to determine MIC of imipenem. CRKP were tested for their antimicrobial susceptibility by Kirby-Bauer modified disc-diffusion technique as per Clinical and Laboratory Standard Institute (CLSI) guidelines and United States Food and Drug Administration (FDA) guidelines. Total 75 K pneumoniae were isolated. Among the isolated K pneumoniae, 28(37.33%) were resistant to carbapenem. Most of the CRKP were recovered from intensive care unit. MIC of CRKP ranged from ≥32μg/ml to ≤4μg/ml. Most of the CRKP were resistant to other antimicrobials. Carbapenem resistance in K pneumoniae is increasing in Bangladesh, which is very alarming and we should give importance on standard guideline of antimicrobials use.

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孟加拉国一家三级保健医院肺炎克雷伯菌碳青霉烯类耐药性
耐碳青霉烯肺炎克雷克菌(CRKP)临床分离株如今已在世界各地广泛传播。本研究旨在调查孟加拉国一家三级保健医院肺炎克雷伯菌对碳青霉烯类药物的耐药性,并观察这些CRKP分离株对其他抗菌素的敏感性。采用标准方法和三糖铁(TSI)琼脂培养基、柠檬酸西蒙斯(Simmons)琼脂培养基、吲哚-尿素(MIU)琼脂培养基等多种生化试验检测肺炎克兰菌。以亚胺培南耐药性为碳青霉烯类耐药指标。采用琼脂稀释法测定亚胺培南的MIC。根据临床和实验室标准协会(CLSI)指南和美国食品和药物管理局(FDA)指南,采用Kirby-Bauer改良圆盘扩散技术检测CRKP的抗菌敏感性。共分离肺炎菌75株。分离的肺炎克雷伯菌中对碳青霉烯类耐药28例(37.33%)。大部分CRKP是从重症监护室恢复的。CRKP的MIC范围为≥32μg/ml ~≤4μg/ml。大多数CRKP对其他抗菌素具有耐药性。孟加拉国肺炎克雷伯菌对碳青霉烯类药物的耐药性正在增加,这是非常令人担忧的,我们应该重视抗生素使用的标准指南。
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