Phenotypic Characterization of Carbapenem Resistant Klebsiella pneumoniae Isolated from Critical Care Areas in a Tertiary Care Teaching Hospital in Eastern Gujarat

Carbapenem Resistant Klebsiella pneumoniae (CRKP) has emerged as a critical public health threat, particularly in intensive care settings. Carbapenems represent the last-resort treatment for multidrug-resistant Gram-negative infections, and resistance to these agents severely limits therapeutic options.

Objectives: To isolate and phenotypically characterise CRKP from clinical specimens received from critical care areas, and to determine the prevalence of metallo-β-lactamase (MBL) and Klebsiella pneumoniae carbapenemase (KPC) using phenotypic detection methods.

Methods: 200 Klebsiella pneumoniae clinical isolates from critical care areas of Zydus Medical College and Hospital, Dahod were processed using conventional phenotypic identification methods. Antimicrobial susceptibility testing was performed by the Kirby Bauer Disk Diffusion method and interpreted per CLSI guidelines 2024/2025. Carbapenem resistance was confirmed and carbapenemase genes were detected using Epsilometer (E-test) strips with EDTA (MBL) and Boronic Acid (KPC).

Results: Of 200 isolates, 113 (56.5%) were carbapenem resistant. The highest prevalence was found in urine (26.6%), pus (24.78%), and sputum (23.9%) samples. The Medical ICU contributed the majority (55.7%) of CRKP isolates. Most patients (71.7%) were below 60 years of age, and 67.26% had a history of frequent or recent hospitalization. MBL genes were detected in 12 isolates (11%) and KPC genes in 2 isolates (1.77%).

Conclusion: The high prevalence of CRKP in critical care units underscores the urgent need for robust antimicrobial stewardship programs, strict infection control practices, and hospital-specific antibiotic policies. Phenotypic methods remain practical and cost-effective tools for CRKP detection in resource-limited settings.