IJSR International Journal of Scientific Research 2277 - 8179 Indian Society for Health and Advanced Research ijsr-7-5-15404 Original Research Paper Prevalence of Carbapenem Resistant Gram Negative Bacteria in Central Referal Hospital, Sikkim. Tamang Dr. Jyotsna Kapil Dr. May 2018 7 5 01 02 ABSTRACT

Carbapenems arebeta–lactam antibiotics, oftenconsidered asdrug ofchoice for treating infections caused by multi–drug resistant Gram  negative  bacteria.This study aimed  in  determingthe prevalence of carbapenem resistant Gram negative bacteria and detecting the production of carbapenemase by Modified Hodge Test(MHT).Antibiotic  susceptibility  testing was done by Kirby Bauer disc diffusion methodand carbapenemase detection by MHT.Out of the total 155 Gram negative bacterial  isolates, the prevalence of carbapenem resistance was found to be 25.80% (40/155). The majority ofthe resistant isolates were detected among theICU patients (53.13%), followed by ward patients (19.30%) and least among OPD patients (11.11%).Carbapenem resistant isolates were obtainedmainly from urine sample (n=12), followed by pus (n=11), endotracheal secretion(n=10), blood (n=4) and sputum (n=3).Carbapenemase production was detected in 30% (12) of the resistant isolatesby MHT with thecarbapenemases production beinghighest in Escherichia coli (50%) and Proteusmirabilis(50%), followed by Klebsiellapneumoniae (42.9%), Pseudomonasaeruginosa (25%),Acinetobacterbaumannii (25%) and not  detected  in  any  of  the  resistant isolates of Enterobactercloacae, BurkholderiacepaciaandStenotrophomonasmaltophila.The prevalence of carbapenem resistant Gram negative bacteria in our hospital is much less than that reported from other studies.Moreover, MHTlacks specificity, giving false positive results in case of AmpCproducers and also lacks sensitivity as it weakly screens the New Delhi Metallo–beta–lactamase producers.