A Comprehensive Study of Phenotypic and Genotypic Techniques to Detect Metallo-β-lactamases in Carbapenem-resistant Escherichia coli (E. coli) and Klebsiella pneumoniae (KP) Strains Derived through Numerous Clinical Specimens in Advanced Health care Facilities

Abstract

In recent years, an increase in Escherichia coli and Klebsiella pneumoniae resistant to carbapenem was reported globally. Due to their high prevalence and extensive range of medical conditions, Escherichia coli and Klebsiella pneumoniae are both confirmed to be major public health concerns. Furthermore, carbapenem resistance restricts treatment options for individuals infected with these bacteria. Consequently, early detection of carbapenem resistance is essential for starting effective therapy, achieving successful management, and avoiding the infection from spreading further in the future. This study’s objective was to identify the phenotypic and genotypic identification of Metallo-β-lactamases (MBL) in carbapenem-resistant E. coli and K. pneumoniae in advanced healthcare facilities. Meropenem resistance was tested in E. coli and K. pneumoniae using the Kirby-Bauer disc diffusion technique. MBL was discovered using a combination of Disc diffusion testing and the Modified Hodge Test. The Polymerase Chain Reaction was used to determine the genotypes of the bla NDM-1 genes that express these enzymes. Out of 427 strains, including 223 E. coli and 204 K. pneumoniae, 35 (8.2%) consisted of carbapenem-resistant, and 29 (82.85%) showed phenotypically verified as metallo-beta-lactamase producers by using the Combined disc test and 20 (57.14%) using the Modified Hodge test. Polymerase Chain Reaction tests for genes detect those three different strains all showed the bla NDM-1 gene. Carbapenemase production and MBL can be recognized with the help of phenotypic combination disc and MHT tests in labs. Since both tests showed 100% concordance, laboratories may use the less expensive CDT instead of the MHT. The current study supports institutional antibiotic stewardship programmes to manage antibiotic use and prevent CRE worldwide.