Evaluation of modified hodge test as an indicator of Klebsiella pneumoniae carbapenemase (KPC) production by using blaKPCgene PCR

Abstract

Introduction: Carbapenems belong to the Beta Lactam group of antimicrobial agents. They are often used as “lastline agents” or “antibiotics of last resort” in critically ill patients. Carbapenem resistance in Enterobacteriaceae may be due to various reasons but Klebsiella pneumoniae Carbapenemase (KPC) enzyme production is the commonest. Phenotypic as well as genotypic methods can be used to detect Carbapenemases. Among the phenotypic tests, Modified Hodge Test (MHT) is relatively easy to perform. Aims and Objectives: This study aimed to determine the prevalence of carbapenem resistance among Enterobacteriaceae isolates and calculate the sensitivity of MHT as an indicator of KPC production. Materials and Methods: All Enterobacteriaceae isolates from clinical samples were included in this study and were screened for Carbapenem resistance. 45 randomly chosen Carbapenem Resistant Enterobacteriaceae isolates were subjected to MHT and blaKPC gene detection by PCR. Results: 2035 Enterobacteriaceae isolates were tested and 5.2% were found to be resistant to Imipenem, 22.9 % were resistant to Meropenem and 4.42 % were resistant to both Imipenem and Meropenem. The sensitivity of MHT was calculated to be 90% and specificity was calculated to be 60%