Frequency of Carbapenem Resistance in the Pathogenic Gram-Negative Bacteria from Hyderabad, Sindh

Carbapenems are β-lactam antibiotics and are often used as a last resort to treat infections caused by the β-lactamase-producing Gram-negative bacteria owing to their ability to withstand hydrolysis by many β-lactamase enzymes. However, the emergence of carbapenem resistance in these pathogens has already been reported. In order to avoid critical situations for public health, regular monitoring and reporting of carbapenem resistance is essential. Objectives: To determine the frequency of carbapenem-resistant Gram-negative pathogens circulating in Hyderabad, Sindh. Methods: This cross-sectional study was carried out for one year. The clinical samples were collected using a convenience sampling technique from patients suspected of bacterial infections. The bacterial isolates were subjected to identification based on their microscopic, cultural, and biochemical characteristics. Sensitivity of each type of Gram-negative pathogen to antibiotics was established in terms of Clinical Laboratory Standards Institute guidelines, with the use of the Kirby-Bauer disk diffusion technique. Results: 400 clinical samples were randomly selected and they were divided into urine (n=212), pus (n=85), blood (n=68), and other (n=35). Their microbiological processing resulted in the recovery of two hundred seventy-seven isolates of Gram-negative bacteria identified as E. coli (31.05%), Enterobacter spp. (24.19%), Pseudomonas spp. (16.25%), Proteus spp. (14.44%), Klebsiella spp. (10.11%), and others (3.96%). The frequency of carbapenem-resistant isolates varied among species, with the highest prevalence in Pseudomonas spp. demonstrating 20% being carbapenem-resistant isolates. Conclusions: Carbapenem resistance in pathogenic Gram-negative bacteria has emerged. The development of carbapenem resistance in these pathogens can be catastrophic for public health.