Prevalence and Pattern Investigation of Carbapenemases Genes in Respiratory Samples from Tertiary Care Referral Institute

A BSTRACT Background: Respiratory tract infections due to viral and bacterial pathogens are linked to significant morbidity and mortality. The detection of coinfections is important to initiate appropriate antimicrobial therapy. Molecular diagnostic testing identifies pathogens at a greater rate than conventional microbiology. Aim: To determine the prevalence and pattern of carbapenmases genes. Materials and Methods: This is a retrospective study carried out in the Microbiology department from January 2022 to June 2023. Respiratory samples were received and processed according to the manufacturer’s instructions by BioFire® Film Array Pneumonia panel. Correlation of film array with culture was done in cases as per request received. Results: Out of 121 cases, the PN panel was positive in 110 (90.9%). The majority of the patients were males (62.8%). The most common age group involved was 41-60 years (32.2%). Bacterial targets were detected in 46 (41.8%), bacterial and viral in 45 (40.9%) and only viral targets in 19 (17.3%) cases. The most common bacterial targets were Acinetobacter baumannii and Klebsiella pneumoniae and viral targets were influenza A or B. Among resistance genes, New-Delhi metallobeta-lactamase (NDM) was the most common followed by extended-spectrum beta-lactamase CTX-M and Oxa-48. Out of 59 bacterial cultures received, growth was seen in 24 (40.7%). Concordant results between both methods were seen in 79.2% of samples (19/24). Conclusion: Film Array PN panel allows the rapid simultaneous detection of a wide number of respiratory organisms, with limited hands-on time. Rapid diagnostic tests that can be properly interpreted for the detection of carbapenem resistance can facilitate therapeutic decision-making.