Online ISSN: 2515-8260

The Evaluation Of Antibiotic Susceptibility Among Carbapenem Resistant Gram-Negative Bacilli In A Tertiary Care Hospital Of Delhi, India

Main Article Content

H. Emmiwai Laloo1 , Saurabh Saxena2

Abstract

1. INTRODUCTION Antimicrobial resistance is a public health emergency at the global level with the situation being critical in developing countries like India (Kumar et al., 2013). Particularly overwhelming is the challenge posed by multidrug resistant Gram-negative bacilli (GNB) belonging to the family Enterobacteriaceae, Pseudomonas species and Acinetobacter species (Giske, Monnet, Cars, & Carmeli, 2008; Viswanathan et al., 2012). The carbapenems are βlactam antibiotics. Those are administeredfor the therapy of infections caused by extended spectrum beta-lactamases (ESBL) producing Gram-negative bacteria (GNB); which causedisorders like meningitis, pneumonia, sinusitis, etc.(Papp-Wallace, Endimiani, Taracila, & Bonomo, 2011). A carbapenemase is an enzyme, which acts as a tool of resistance used by bacteria to defend themselves against various types of antibiotics like imipenem, meropenem, ertapenem, doripenem known as the carbapenem group (Nordmann, Naas, & Poirel, 2011). Their origins are from β -lactamase enzymes, which usually provide resistance against βlactam antibiotics viz. penicillin, cephalosporin, etc. Found in Gram-negative bacilli with usual occurrence of sepsis. It is also associated with other types of resistance like ESBL mechanisms, providing resistance to several other antibiotics like quinolones and aminoglycosides (Zhang et al., 2014). It is very difficult to deal with the infections ofcarbapenemase-producing bacteria; which causes a high mortality rate worldwide.(Khan, J. A., et al 2018) Thus, a rise and worldwide spread of carbapenemase producing GNB, especially Enterobacteriaceae is a major concern because they are often resistant to all βlactam and other antibiotics (Sun et al., 2016). Majority of carbapenemasesare the members of 3 classes of β-lactamases, namey Ambler class A, B [metallo-betalactamases (MBL)] and D. Molecular studies have determined that Ambler class A and class D are serine enzymes possessing a serine moiety at their active site and Ambler class B or MBLs require a divalent cation as a metal cofactor, usually zinc (Sun et al., 2016, Ahmad, A. et al 2020)). Continuous mutations among the genes encoding β-lactamases and natural selection due to high use of antibiotics results in the development of newer beta lactamases. Among these, transferrable MBLs are of major concern as they hydrolyse almost all drugs in the class (Pasteran, Mendez, Guerriero, Rapoport, & Corso, 2009).

Article Details