PT  - JOURNAL ARTICLE
AU  - Vamsi, Sreeja K.
AU  - Moorthy, Rama S.
AU  - Hemiliamma, Mary N.
AU  - Chandra Reddy, Rama B.
AU  - chanderakant, Deepak J.
AU  - Sirikonda, Shravani
TI  - Phenotypic and genotypic detection of carbapenemase production among gram negative bacteria isolated from hospital acquired infections
AID  - 10.15537/smj.2022.43.3.20210809
DP  - 2022 Mar 01
TA  - Saudi Medical Journal
PG  - 236--243
VI  - 43
IP  - 3
4099  - http://smj.org.sa/content/43/3/236.short
4100  - http://smj.org.sa/content/43/3/236.full
SO  - Saudi Med J2022 Mar 01; 43
AB  - Objectives: To identify the carbapenemase producing Gram-negative bacteria (GNB) by phenotypic methods and to confirm the presence of resistant genes using real-time polymerase chain reaction (PCR).Methods: This was a prospective study carried out at the Department of Microbiology, Sri Venkata Sai Medical College and Hospital, Mahabubnagar, India, from March 2018-2021. All samples were screened for carbapenem resistance by disc diffusion method and the VITEK®2 compact system (bioMérieux, France). Detection of carbapenemase was carried out using RAPIDEC®CARBA NP test (Biomeriux Private Limited, South Delhi, India), screening for metallo-β-lactamases (MBL) was carried out by double disk synergy test (DDST), and genotypic characterization by real-time PCR.Results: Among the 1093 Gram-negative bacilli identified, 220 (17.0%) were resistant to carbapenems by both tested methods. Carbapenemase detection using the RAPIDEC®CARBA NP test indicated that 207 (94.0%) were carbapenemase producers, of which 189 (91.2%) were MBL producers. The most common carbapenemase genes identified were New Delhi metallo-β-lactamase (NDM; 47.3%), followed by the co-existence of genes in combination of NDM, with Verona integron-mediated metallo-β-lactamase (VIM; 39.6%), VIM and oxacillin hydrolyzing enzymes-48 (OXA-48; 4.3%), and OXA-48 (1.4%).No gene of active on imipenem, Klebsiella pneumonia carbapenemase, VIM, or OXA-48 alone was detected.Conclusion: This study suggests routine carbapenem resistance testing among multi-drug resistant-GNBs, as most of these infections occur in hospitals. In addition, there is a possibility that these highly antibiotic-resistant genes could spread to other bacteria resulting in further dissemination.