Detection of Extended Spectrum Beta Lactamase and Carbapenemase Production in Klebsiella Pneumoniae in a Tertiary Care Hospital

Klebsiella species belonging to enterobacteriaceae family is both a community acquired and hospital based pathogen. Multidrug resistant Klebsiella species like extended-spectrum--lactamase (ESBL) producers and carbapenemase producers are increasing in Enterobacteriaceae family, it is worrisome as they are gut commensals and may spread to the community. Aims To isolate, identify and antibiotic susceptibility pattern of Klebsiella pneumoniae (K. pneumoniae) and to detect the ESBL and Carbapenemase production. Methods and Material K. pneumonia isolated from various samples was identified according to standard microbiological techniques. Antimicrobial sensitivity testing was performed by Kirby Bauer disk diffusion method. ESBL production was done by combined disc diffusion method and carbapenemase production was confirmed by Modified Hodge test (MHT). Results Two hundred and fifty isolates of K. pneumoniae were isolated from various clinical samples. All ESBL positive isolates showed 100 % sensitivity to imepenem and meropenem and all carbapenemase producing isolates were 100 % sensitive to colistin, tigecycline and polymyxin B. Of 250 K. pneumoniae isolates, 52 (20.8 %) were carbapenemase producers, among them 44 (84.61 %) were positive by MHT. Conclusions As Modified Hodge test is a sensitive and rapid test for K. pneumoniae carbapenemase production, it can be recommended to screen all the isolates which are showing resistance to carbapenems.