Carbapenem Resistance Among Common Enterobacteriaceae Clinical Isolates in Part of North-East India

Background: Enterobacteriaceae, the normal dwellers in the human intestine, are commonly associated with a variety of community-acquired and nosocomial infections. An emerging trend of antibiotic resistance among these strains is a notable issue globally; a more serious threat is the resistance against the available last resort antibiotics- the carbapenems. Objective: The objective of our study was intended to determine the burden of resistance towards common antibiotic classes so as to address the gap of drug resistance prevalence data, among the Enterobacteriaceae isolates obtained from the health settings in this region. Methodology: A cross-sectional study was done with an inclusion of clinical isolates collected from varied sources from health settings in upper Assam. The isolates were identified based on standard methods of morphology study and biochemical tests. The identified isolates were then subjected to antibiotic susceptibility testing by following the Kirby-Bauer disc diffusion method, and the result was interpreted as per the CLSI guidelines. The resistance of the reported carbapenem-resistant isolates was confirmed by minimum inhibitory concentration (MIC) determination using a commercial E-strip kit. Results: Among the enterobacterial isolates Klebsiella spp. accounted for the majority, followed by Escherichia coli, Citrobacter spp., Shigella spp. and others. Multi-drug resistance (MDR) was noted among 67.6% isolates; however, carbapenem resistance was confirmed in 18.9% of the total Enterobacteriaceae isolates. Conclusion: Higher prevalence of resistance towards carbapenems, among the Enterbacteriaceae isolates of upper Assam seems to be an upcoming threat to the region, limiting the treatment options in the future.