Authors : Shalini Pandey, Seema Nimbarte, P.R.Bhandari and Y.S.Thakar
Page Nos : 85-91
Description :
The global spread of multidrug resistant gram negative bacteria is quite well evident. Carbapenem class of antibiotics are favoured treatment options for severe and life threatening infections due to gram negative bacteria especially by those belonging to Enterobacteriaceae, Pseudomonas, Acinetobacter and other non-fermenting Gram negative bacteria. However, these organisms have started developing resistance to carbapenem antibiotics mainly by production of carbapenemase enzymes which have multiple genetic determinants viz Klebsiella pneumonia Carbapenemase (KPC), New Delhi Metallo-beta-lactamases (NDM), OXA, IPM, VIM etc. and occasionally by Porin mutation and efflux mechanisms. This results in limited choice of treatment. The increasing prevalence of carbapenemase producing organisms (CPO) is a matter of concern; hence detection of CPOs by finding at carbapenemase production in them and eradicating them with proper antimicrobial therapy is essential. There are many genetic loci in CPOs for carbapenemase production. The CPOs can be detected by different phenotypic methods as well as genotypically by PCR test. There is no single phenotypic test which is rapid, simple and can detect all types of Carbapenemases. However, they are easy to perform, accurate, economical and feasible in moderately equipped laboratories. In view of rapid increase in drug resistance among bacteria it is essential to detect carbapenemase production to advocate proper therapy to eradicate the resistant bugs and rationalize the treatment.
