Utilization of MacConkey-Meropenem screening Agar for the Detection of Carbapenem Resistanant Enterobacteriaceae in a tertiary care hospital

International Journal of Medical Science

© 2015 by SSRG - IJMS Journal

Volume 2 Issue 4

Year of Publication : 2015

Authors : Sanjeev Kumar , Anamika Vyas and S.K.Mehra

10.14445/23939117/IJMS-V2I4P101

How to Cite?

Sanjeev Kumar , Anamika Vyas and S.K.Mehra, "Utilization of MacConkey-Meropenem screening Agar for the Detection of Carbapenem Resistanant Enterobacteriaceae in a tertiary care hospital," SSRG International Journal of Medical Science, vol. 2,  no. 4, pp. 1-5, 2015. Crossref, https://doi.org/10.14445/23939117/IJMS-V2I4P101

Abstract:

Introduction: The increasing frequency of Carbapenem Resistant Enterobacteriaceae (CRE) has become a serious threat to public health due to production of different types of carbapenemases, multi-drug resistant (MDR) and limited treatment options. The present study was planned to evaluate the MacConkey agar supplemented with meropenem at 1µg/ml, as a screening agar for the detection of CRE among the clinical isolates of Enterobacteriaceae. Methods: The total 1080 Enterobacteriaceae species isolated from different clinical samples. All the isolates were identified based on standard bacteriological techniques. All these isolates were screened for meropenem resistance by Kirby-Bauer disk diffusion method according to CLSI guidelines. Carbapenem resistant isolates were inoculated on screening agar (MacConkey agar supplemented with meropenem at concentration of 1µg/ml) and also tested for carbapenemase production by phenotypic method (combined disk method). Results: Among the 1080 clinical isolates of Enterobacteriaceae, 50 isolates showed resistance to carbapenem by Kirby Bauer disk diffusion method. All of these 50 isolates were grown on carbapenem screening agar. Of these 50 carbapenem resistant isolates, Eighteen (36%) E.coli, 22(44%) Klebsiella species, 6(12%) Enterobacter species, 3(6%) Citrobacter species and 1(2%) isolate was Proteus vulgaris. Out of 50 Carbapenemase producing Enterobacteriaceae, 18(36%) KPC producers, 15(30%) MBL producers, 13(26%) were both MBL&KPC producers and 4(8%) isolates were negative for MBL&KPC production by combined disk method. Conclusion: MacConkey agar with meropenem 1µg/ml is the most appropriate for detection of carbapenem resistant Enterobacteriaceae (CRE). This screening agar plate provides a rapid, sensitive, convenient and relatively cost effective method for the screening of CRE.

Keywords:

Screening agar, CRE, Meropenem 1 µg, Cost-effective.

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