Prevalence of Carbapenem-Resistant Escherichia coli and Klebsiella pneumoniae in Rural Uttar Pradesh

Abstract

Introduction: In recent years, increased incidences of carbapenem resistance among Escherichia coli and Klebsiella pneumoniae have been reported worldwide. Due to the higher prevalence and wide range of clinical infections, E. coli and K. pneumoniae are considered great risks for public health. Furthermore, carbapenem resistance limits the treatment options in individuals infected with E. coli and K. pneumoniae. Thus, rapid detection of carbapenem resistance is essential to initiate appropriate treatment and effective management and prevent further dissemination. In the present study, we aimed to explore the prevalence of carbapenem-resistant E. coli and K. pneumoniae at a tertiary care hospital in rural Uttar Pradesh. Materials and Methods: A cross-sectional study was performed at Government Medical College, Azamgarh, in collaboration with Santosh Medical College, Ghaziabad. A total of 2736 clinical specimens comprising urine (1939), pus and wound swabs (486), sputum and throat swabs (257), and other samples (54) were collected following the standard guidelines and were processed for culture by standard bacteriological methods. After obtaining the growth, Gram staining and standard biochemical reactions were performed for the identification of E. coli and K. pneumoniae. All these isolates were subjected to antibiotic sensitivity testing for carbapenem by Kirby–Bauer disc diffusion method. Results: Of the 2736 specimens, 48.57% showed the growth of various organisms. Of these, 59.51% of isolates showed the growth of Enterobacteriaceae, of which 60.93% among them were E. coli whereas 26.92% were K. pneumoniae. The overall prevalence of carbapenem resistance in the present study was found to be 29.35%. Among the carbapenem-resistant isolates, 68.13% were E. coli whereas 31.86% were identified as K. pneumoniae. Conclusion: Carbapenem resistance in E. coli and K. pneumoniae isolates in the present study was found to be higher compared to previous studies from India. Our study highlights the urgent need of proper monitoring, judicious use of antibiotics, and implementation of strict infection control practices in this region.