Carbapenem Resistance in Escherichia coli and Klebsiella pneumoniae Isolated from Patients with Community Acquired Infections in Rural Population of Haryana

Carbapenem-resistant Escherichia coli and Klebsiella pneumoniae are known to cause wide range of clinical infections and they have been increasingly reported worldwide, leading to consequential public health threat. The present study aimed to find out the carbapenem resistance rate among E. coli and K. pneumoniae in the rural population Haryana. A total of 400 isolates, comprising of 200 each of E. coli and K. pneumoniae from rural population attending outpatient department were subjected to carbapenem resistance detection methods viz., screening test using ertapenem disc and phenotypic confirmatory test by Modified Hodge test (MHT). Prevalence of carbapenem resistant E. coli and K. pneumoniae by screening test were detected to be 73/200 (36.5%) and 64/200 (32%) strains respectively while confirmatory MHT detected carbapenem resistance in 46/200 (23%) and 38/200 (19%) strains respectively. Higher resistance was detected in carbapenem resistant K. pneumoniae isolates for co-trimoxazole, cefepime, ciprofloxacin compared to carbapenem resistant E. coli. While that for gentamicin, amikacin, fosfomycin, and tigecycline were comparable. The present study highlighted the carbapenem resistance scenario in the rural setup of India and the known efficiency of MHT over screening test in the detection of carbapenemase production.