Occurrence and Detection of blaKPC Producing Klebsiella pneumoniae in an Indian Tertiary Hospital

Background: Klebsiella pneumoniae is one of the most important gram-negative bacterial pathogens which has caused worldwide concern because of its association with life threatening nosocomial infections and its multidrug-resistant (MDR) property. As a result of the increased use of antibiotics; Carbapenemases are widespread in Enterobacteriaceae family and particularly in K. pneumoniae so effective treatment options are decreasing. The aim of this study was to detect blaKPC gene in Klebsiella pneumoniae by conventional PCR and to compare the phenotypic, ie Modified hodge test and genotypic methods ie PCR for detection of KPC carbapenemases of the recovered isolates of Klebsiella pneumoniae.

Study Design: Cross Sectional Prospective.

Place and Duration of Study: This study was conducted in the Department of Microbiology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar; in India over a period of one year and three months (june 2014-september 2015).

Methods: This study included all isolates of Klebsiella pneumoniae recovered from blood culture of the patients. The identification and antimicrobial susceptibility were done on Vitek 2 compact. Isolates that were resistant to meropenem were included for phenotypic (Modified Hodge Test) and genotypic (Conventional Polymerase Chain Reaction) tests.

Results: A total of 70 Klebsiella pneumoniae isolates were recovered. Out of these 55 were meropenem resistant and 15 were sensitive. 76.3% isolates were MHT positive and 23.7% were negative. blaKPC gene was present in 64.5% and absent in 34.5% isolates. Out of 42 MHT positive isolates 81% were carrying blaKPC gene.

Conclusion: It was seen that a higher prevalence of blaKPC producing Klebsiella pneumoniae were isolated from patients admitted in ICU (intensive care unit). So formulation of an antimicrobial policy and its strict implementation is needed along with appropriate infection control measures to curtail its emergence and spread.