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| Year:
2026 |
Month:
April
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Volume:
15 |
Issue:
2 |
Page:
MO01 - MO05 |
Detection of Common Genotypes of Carbapenemase in Carbapenem-resistant Enterobacteriaceae Isolated from Lower Respiratory Tract Infections at a Tertiary Care Hospital in Southern India:
A Cross-sectional Study
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Correspondence
UB Thushara, Renu Mathew, Anjali Ann Jacob, MB Manju,
UB Thushara,
Department of Microbiology, Believers Church Medical College Hospital,
Thiruvalla, Kerala, India.
E-mail: thusharaubhuvan@gmail.com :
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Introduction: Lower Respiratory Tract Infections (LRTI) caused by Carbapenem-resistant Enterobacteriaceae (CRE) has emerged as a major threat to modern medicine and have limited treatment options available. Timely detection of genotypes of carbapenemases in the clinical laboratory is of paramount importance to give appropriate treatment.
Aim: To detect the proportion of common genes responsible for carbapenemase production (genotype) from CRE in a Tertiary Care Hospital in Southern India.
Materials and Methods: The present cross-sectional study was conducted in the Department of Microbiology, Believers Church Medical College Hospital, Thiruvalla, Kerala, India, from March 2025 to September 2025. The study included a total of 125 isolates obtained from patients with (LRTIs). CRE reported from aerobic bacterial culture and sensitivity testing of respiratory samples that show resistance to one or more carbapenems (meropenem, imipenem or ertapenem) was subjected to carbapenemase gene detection. The genes detected were NDM-1, OXA-48, KPC and VIM using a Polymerase Chain Reaction (PCR) assay. Bacterial identification and antibiotic susceptibility testing were performed using the VITEK® 2 Compact system. The statistical analysis was done in Statistical Package for Social Sciences (SPSS) version 21.0. The association between variables were tested using Pearson’s Chi-Square Test. The p-value of <0.05 was considered statistically significant.
Results: Out of the total 125 CRE isolates tested, Klebsiella pneumoniae was isolated from 123 (98.4%) samples and Enterobacter cloacae from 2 (1.6%) samples. The most common genotype of carbapenemase observed was NDM-1+OXA-48 33 (26.4%), followed by NDM-1 alone 28 (22.4%) and OXA-48 alone 28 (22.4%). NDM-1 (alone and in combination with other genes) constituted about 83 (66.4%), and OXA-48 (alone and in combination with other genes) was present in 75 (60%) of the isolates.
Conclusion: The present study results indicate that NDM-1, followed by OXA-48, were responsible for carbapenemase production in more than 50% of CRE isolates tested. Among the total CRE isolates studied, 96.8% isolates were carbapenemase producers and 3.2% were non-carbapenemase producers. This high percentage of Carbapenemase-producing CRE is alarming. So, prompt detection of genotypes of CRE, strict anti-microbial stewardship practices, and infection control activities are absolutely essential in health care facilities to curtail CRE infections.
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