Does the presence of Klebsiella pneumoniae carbapenemase and New Delhi metallo‑β‑lactamase‑1 genes in pathogens lead to fatal outcome.
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Date
2016-10
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Abstract
Introduction: Infections due to multidrug‑resistant (MDR) pathogens are a medical challenge. There is considerable
apprehension among clinicians regarding pathogens reported as carrying New Delhi metallo‑β‑lactamase‑1 (NDM)
and Klebsiella pneumoniae carbapenemase (KPC) genes from their patients. In the face of extremely high rates of
antimicrobial resistance, it is essential to gauge the clinical significance of isolation of pathogens carrying these genes
from clinical samples. This study compares the outcome of patients infected with pathogens carrying NDM/KPC
genes versus those without these genes. Methods: The study was conducted over a 1‑year period at a Level‑1 trauma
centre. Hospital‑acquired infections were diagnosed on the basis of CDC’s criteria. The correlation of isolation of
a multi‑resistant pathogen carrying KPC or NDM genes with the clinical outcome was ascertained. Results: A total
of 276 consecutive patients admitted to the Intensive Care Units/wards of the JPNA Trauma Centre were included in
this study. Of the 371 isolates recovered from these patients, 116 were from patients who had a fatal outcome. The
difference in prevalence of blaNDM and blaKPC was not significant in any genera of Gram‑negative pathogens isolated
from patients who survived versus those who had a fatal outcome. Conclusion: Isolation of MDR pathogens carrying
NDM/KPC genes from clinical samples is not always a harbinger of a fatal outcome. Efforts should be made to prevent
cross‑transmission of these pathogens.
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Keywords
Fatal, Klebsiella pneumoniae carbapenemase, multidrug resistance, New Delhi metallo‑β‑lactamase‑1, outcome
Citation
Mathur P, Sagar S, Kumar S, Sharma V, Gupta D, Lalwani S, Rani R, Muruganantham A. Does the presence of Klebsiella pneumoniae carbapenemase and New Delhi metallo‑β‑lactamase‑1 genes in pathogens lead to fatal outcome. Indian Journal of Medical Microbiology. 2016 Oct-Dec; 34(4): 495-499.