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Indian J Med Microbiol. 2016 Oct-Dec;34(4):495-499. doi: 10.4103/0255-0857.195367.

Does the presence of Klebsiella pneumoniae carbapenemase and New Delhi metallo-β-lactamase-1 genes in pathogens lead to fatal outcome?

Author information

  • 1Department of Laboratory Medicine, Jai Prakash Narayan Apex Trauma Centre, New Delhi, India.
  • 2Department of Surgery, Jai Prakash Narayan Apex Trauma Centre, New Delhi, India.
  • 3Department of Orthopedica, Jai Prakash Narayan Apex Trauma Centre, New Delhi, India.
  • 4Department of Neurosurgery, Jai Prakash Narayan Apex Trauma Centre, New Delhi, India.
  • 5Department of Forensic Medicine, Jai Prakash Narayan Apex Trauma Centre, New Delhi, India.
  • 6Department of Laboratory Medicine, Jai Prakash Narayan Apex Trauma Centre, All Institute of Medical Sciences, New Delhi, India.

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 blaNDMand blaKPCwas 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.

PMID:
27934829
DOI:
10.4103/0255-0857.195367
[PubMed - indexed for MEDLINE]
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