Abstract

Comparative Evaluation of In-Vitro Doripenem Susceptibility with Other Carbapenem Antibiotics among Gram Negative Bacterial Isolates Obtained from VAP Patients in a Super-Speciality Hospital: A Pilot Study

Author(s):Mohit Bhatia, Poonam Sood Loomba, Bibhabati Mishra, and Vinita Dogra

Context: Few studies have been published about the in vitro Doripenem susceptibility profiles of Gram negative bacteria obtained from lower respiratory tract samples of patients suffering from Ventilator Associated Pneumonia (VAP). Aims: To generate preliminary data on in vitro Doripenem susceptibility profile of Gram negative bacteria isolated from mucus trap samples of patients suffering from VAP and also compare the organism wise in vitro susceptibility pattern of Doripenem, ertapenem, imipenem and meropenem. Settings and Design: A pilot study was conducted in a super speciality hospital from October 2015 to June 2016. Material and Methods: Patients on ventilator admitted in various intensive care units (ICUs) satisfying the defining criteria for VAP as per standard guidelines were included in the study. Seventy-Seven Gram negative bacterial isolates obtained from mucus trap samples of fifty-seven non-consecutive patients were identified and subjected to antibiotic susceptibility testing (AST) as per standard guidelines. Statistical analysis used: Descriptive statistics. Results: Klebsiella pneumoniae followed by Acinetobacter baumannii and Pseudomonas aeruginosa were the predominant bacterial isolates. The Doripenem resistance rates among K. pneumoniae, A. baumannii and P. aeruginosa were 55.10%, 96.43% and 52.94% respectively. There was 100% concordance between resistance to Doripenem, imipenem and meropenem respectively in A. baumannii. Fourteen (82.35%) out of seventeen Enterobacteriaceae spp. (Klebsiella pneumoniae and Escherichia coli) Doripenem resistant isolates were also resistant to ertapenem, imipenem and meropenem respectively. In case of P. aeruginosa, five (55.55%) Doripenem resistant isolates were also resistant to imipenem and meropenem respectively. Conclusions: This is probably the first report on high level of Doripenem resistance in K. pneumoniae from India. More number of studies should be conducted in order to substantiate our findings.

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