Retrospective Analysis of Outcomes in Patients Growing Gram Negative Multidrug Resistant (MDR) Isolates from a Tertiary Care Centre

Dr. Pradip Kumar Bhattacharya; Dr. Saurabh Agarwal; Navya Guwalani; Nimita Deora

Volume : VII, Issue : VIII, August - 2018

Retrospective Analysis of Outcomes in Patients Growing Gram Negative Multidrug Resistant (MDR) Isolates from a Tertiary Care Centre

Dr. Pradip Kumar Bhattacharya, Dr. Saurabh Agarwal, Navya Guwalani, Nimita Deora

Abstract :

Introduction– Resistant strains of Enterobacteriaceae and nonfermentershave emerged recently due to many variable reasons with the use of carbapenems. Resistance to carbapenems is mostly due to enzymes called carbapenemase. Various studies have been conducted to evaluate the prevalence of carbapenemase producers. Aims– The present retrospective study was conducted to determine the prevalence, resistance pattern and mortality of carbapenemase producers in our tertiary care centre. Materials and Methods– Samples were collected from patients admitted to the hospital wards and ICU. Gram negative isolates were screened out from all clinical samples sent to microbiology laboratory. Only Class A carbapenemase, Class B metallo beta–lactamase (MBL) and extended spectrum beta–lactamase (ESBL) isolates were considered for this retrospective analysis.Results– A total of 1344 organisms were isolated in this study. Of those 1344 strains, 995 strains were gram negative bacteriaand 349 strains were gram positive bacteria. The prevalence of Enterobacteriaceaeand nonfermentingstrains producing class A carbapenemase, class B MBL type carbapenemase and ESBL was 34.17%(340/995), 11.35% (113/995)and 7.8 % (78/995)respectively. The 46.63% (464/995) strains were other gram negative bacteria. The observed mortality rates among patients with class A carbapenemase, class B MBL and ESBL were 19.41% (66/340), 31.8% (36/113) and 12.8% (10/78) respectively. Conclusion–The prevalence of class A carbapenemase and MBL producers is high in our tertiary care setup. Associated mortality, along with duration of ICU stay and number of ventilator days, is also high.