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Emerging resistance to carbapenems in a tertiary care hospital in north India

Ekta Gupta1, Srujana Mohanty, Seema Sood

  • 1Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India.

The Indian Journal of Medical Research
|August 24, 2006
PubMed
Abstract

Insights

Antibiotic resistance to meropenem and imipenem is increasing in Gram-negative bacteria in India. Pseudomonas spp. showed the highest resistance, with higher rates in intensive care units, necessitating judicious antibiotic use.

Area of Science:

  • Clinical microbiology and infectious diseases.
  • Antimicrobial resistance surveillance.
  • Pharmacology of beta-lactam antibiotics.

Background:

  • Carbapenems (meropenem, imipenem) are crucial for treating multi-drug resistant Gram-negative bacilli infections.
  • Emerging resistance to carbapenems in India, particularly in Pseudomonas spp., poses a significant clinical challenge.
  • Understanding local antibiotic susceptibility patterns is vital for effective treatment strategies.

Purpose of the Study:

  • To retrospectively evaluate the antibiotic susceptibility patterns of meropenem and imipenem.
  • To assess resistance trends among Gram-negative bacterial isolates in a tertiary care hospital in North India.
  • To identify specific bacterial species with high carbapenem resistance.

Main Methods:

  • Analysis of 2626 Gram-negative bacterial isolates from clinical samples.
  • Testing for extended-spectrum beta-lactamase (ESBL) production using the double disk diffusion method.
  • Determination of meropenem and imipenem susceptibility using NCCLS guidelines for ESBL-positive isolates.

Main Results:

  • Overall resistance to meropenem was 22.16% and to imipenem was 17.32%.
  • Pseudomonas spp. exhibited the highest resistance rates (Meropenem: 37.6%, Imipenem: 30%).
  • Carbapenem resistance was significantly higher in isolates from intensive care units (ICUs) compared to non-ICU patients.

Conclusions:

  • Significant resistance to meropenem and imipenem exists among Gram-negative ESBL-positive bacteria in North India.
  • The findings highlight the urgent need for increased clinician awareness regarding judicious antibiotic prescribing.
  • Continuous monitoring of antibiotic resistance patterns is essential to guide antimicrobial stewardship efforts.

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