DETECTION OF NDM,VIM, IMP METALLO-ß-LACTAMASE GENES IN KLEBSIELLA PNEUMONIAE ISOLATED FROM CLINICAL SAMPLES AT A TERTIARY CARE CENTRE: A STUDY FROM SOUTHERN RAJASTHAN

Background: The increased prevalence of carbapenem-resistantance caused by Metallo- -lactamase (MBL) is worrisome in clinical & community settings world widely. The mortality rate associated with infections caused by MBLs producing organisms ranging from 18 to 67% . This study aimed to determine the prevalence of Metallo- -lactamase genes NDM, VIM and IMP among klebsiella pneumoniae isolates in various clinical samples pus, urine, blood samples, respiratory secretions (tracheal & endotracheal), peritoneal-uid. Methods: It is a descriptive cross-sectional study carried out to detect MBL genes NDM, VIM and IMP by combined disc diffusion test and multiplex realtime PCR reactions among 200 klebsiella pneumoniae isolates, at MBGH hospital during Jan.2023 to Jun2023. The standard microbiological methods were used for the isolation and identication of klebsiella pneumoniae isolates. All the 200 isolates of klebsiella pneumoniae were screened by the carbapenem (Meropenem/Imipenem/Ertapenem)resistant by Kirby Bauer Disc Diffusion method on Muller Hinton Agar. The conrmatory detection of Metallo- -lactamase (MBL) was done by the combined disc diffusion test(CDT), further all the combined disc test positive isolates were enrolled for RTPCR. Results: Out of the 200 klebsiella pneumoniae isolates, 80(40%) were found resistant to carbapenem (Meropenem/Imipenem/Ertapenem). 55 (27.5%) isolates were found positive by combined disc test among all the 80 klebsiella pneumoniae isolates. prevalence of MBL genes by multiplex RTPCR assays among 55 combined disc positive klebsiella pneumoniae isolates, we found 44(22%) isolates positive and 11(5.5%) were found as negative. New Delhi Metallo beta lactamase was the most frequent genes 27(49%), followed by Verona integron Metallo beta-lactamase (VIM) was 11(20%), and consequently, imipenemase (IMP) was 6(10%). There was a statistically, signicant association between the combined disc test and the RTPCR assay (P.value <1). Conclusion: This study revealed the increase in trend of carbapenemase production and a high prevalence of MBL genes in klebsiellae pneumoniae isolates from MBGH Hospital which were not previously established.