Emerging Carbapenem Resistance in Enterobacteriaceae

Objective: To determine the frequency of carbapenem resistance in Enteriobacteriaceae. Study design: Cross-sectional study. Setting: Study was carried out from January 2011 to December 2011, in the Department of Microbiology, Basic Medical Sciences Institute (BMSI), Jinnah Postgraduate Medical Centre (JPMC), where 500 samples were collected from patients admitted in wards and ICUs of JPMC. Method: Specimens were collected from patients admitted in wards and ICUs of JPMC and processed for the diagnosis in the department of Microbiology, BMSI. The nature of samples was Urine, Pus, Respiratory secretions and Blood. The samples were collected after taking all the necessary aseptic measures and transported to the Department and processed by standard methods. The culture positive samples were analyzed for further identification and antimicrobial sensitivity was done according to CLSI 2009. Result: In this study out of (373) positive cases, (402) organisms were isolated. Out of that 200 (49.75%) were Enterobacteriaceae, others were Gram-positive and Gram-negative rods other than Enterobacteriaceae. Escherichia coli were leading pathogen (65%) among Enterobacteriaceae. Out of 200 only 12 (6%) were identified as CRE by Imipenem and Meropenem disc diffusion test. The sensitivity pattern of CRE and Non-CRE shows a significant difference. All the CRE were resistant to commonly used antibiotics. Non-CRE was resistant to Ampicillin, Amoxicillin-clavulanic acid Cephalosporins and Quinolones. Sensitivity against Amikacin, Carbapenems, Colistin and Tigecycline was high. Conclusion There is an alarming increase of infections caused by Carbapenem and other antibiotics resistant Enterobacteriaceae.