Lathakumari Rahul Harikumar, Vajravelu Leela Kakithakara, Thulukanam Jayaprakash, Nair Dakshina M, Vimala Poornima Baskar, Panneerselvam Vishnupriya
Department of Microbiology, SRM Medical College Hospital and Research Centre, SRM Institute of Science and Technology (SRMIST), Kattankulathur, Chengalpattu, Tamil Nadu, India.
Front Med (Lausanne). 2025 May 30;12:1571231. doi: 10.3389/fmed.2025.1571231. eCollection 2025.
Carbapenem-resistant Gram-negative bacteria (CR-GNB) pose a serious global health threat, especially in low- and middle-income countries. Local surveillance is crucial for informing antimicrobial stewardship and infection control strategies. This study aimed to evaluate the prevalence, demographic distribution, and temporal fluctuations of carbapenem resistance among key Gram-negative pathogens in a South Indian tertiary care center over a two-year period.
A retrospective study was conducted on 8,359 non-duplicate Gram-negative isolates obtained from clinical specimens between July 2022 and July 2024. Organisms were identified, and antimicrobial susceptibility was determined using the VITEK 2 Compact system (BioMérieux). Resistance to imipenem (IPM) and meropenem (MEM) was assessed. Data were stratified by age, sex, ward type, specimen source, and quarterly distribution. A subset of resistant isolates underwent molecular screening for carbapenemase genes using real time PCR.
Carbapenem resistance was observed in 24% (2007) of Gram-negative isolates. (48.0%) and (38.6%) accounted for the majority of resistant cases. Resistance was significantly higher in males (64.3%) and in patients aged 61-80 years ( < 0.001). Surgical wards showed greater resistance rates compared to medical departments. A peak in resistance was identified during January-March 2023, particularly for (76.3%). IPM-MEM resistance discrepancies were found in and species. Gene profiling of resistant strains revealed the predominance of , in
The findings reveal a high and fluctuating burden of carbapenem resistance, especially in elderly males and surgical settings. Continuous surveillance and targeted interventions are vital to curbing the spread of CR-GNB in high-risk healthcare environments.
耐碳青霉烯类革兰氏阴性菌（CR-GNB）对全球健康构成严重威胁，尤其是在低收入和中等收入国家。本地监测对于制定抗菌药物管理和感染控制策略至关重要。本研究旨在评估印度南部一家三级护理中心在两年期间主要革兰氏阴性病原体中碳青霉烯耐药性的流行情况、人口分布和时间波动。
对2022年7月至2024年7月期间从临床标本中获得的8359株非重复革兰氏阴性分离株进行回顾性研究。使用VITEK 2 Compact系统（生物梅里埃公司）鉴定微生物并确定其药敏性。评估对亚胺培南（IPM）和美罗培南（MEM）的耐药性。数据按年龄、性别、病房类型、标本来源和季度分布进行分层。对一部分耐药分离株使用实时PCR进行碳青霉烯酶基因的分子筛查。
在24%（2007株）的革兰氏阴性分离株中观察到碳青霉烯耐药性。（48.0%）和（38.6%）占耐药病例的大多数。男性（64.3%）和61-80岁患者的耐药性显著更高（<0.001）。外科病房的耐药率高于内科。在2023年1月至3月期间发现耐药性高峰，特别是对于（76.3%）。在和物种中发现了IPM-MEM耐药差异。耐药菌株的基因分析显示在中占优势。
研究结果揭示了碳青霉烯耐药性的高负担且波动较大，尤其是在老年男性和外科环境中。持续监测和针对性干预对于遏制CR-GNB在高风险医疗环境中的传播至关重要。
