MOLECULAR CHARACTERIZATION OF CARBAPENEMASE GENES (CARBA 5) AMONG MULTIDRUG-RESISTANT OCULAR PATHOGENS IN CENTRAL INDIA
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Keywords
Ocular infections, Multidrug-resistant bacteria, Carbapenem resistance, Carbapenemase genes, Carba 5 rapid test.
Abstract
Background: Ocular infections caused by multidrug-resistant (MDR) bacteria, especially those harboring carbapenemase enzymes, pose a significant challenge to effective treatment and can lead to severe visual impairment. Carbapenemase genes such as bla KPC, bla NDM, bla VIM, bla IMP, and bla OXA-48-like contribute to carbapenem resistance and are detectable by the Carba 5 molecular panel.
Aim: To molecular characterize carbapenemase genes among MDR ocular bacterial pathogens from a tertiary care hospital in Central India and evaluate their antibiotic resistance patterns.
Methods: A Observational study were conducted from January 2024 to January 2025 involving 250 ocular specimens. Bacterial isolates were identified and tested for antibiotic susceptibility according to CLSI guidelines (2021). MDR carbapenem-resistant isolates underwent phenotypic screening followed by genotypic detection of carbapenemase genes using the NG-Test CARBA 5 rapid immune chromatographic assay, with confirmation.
Results: A total of 250 ocular specimens were analyzed, with 84% yielding bacterial growth. Conjunctival swabs were the most common source, followed by corneal scrapings and lacrimal sac discharge. Among the 210 isolates, Staphylococcus aureus was the predominant pathogen, with Gram-negative bacilli such as Pseudomonas aeruginosa and Klebsiella pneumoniae also significantly represented. Multidrug resistance was observed in isolates, 9 (4.2%) that showed. Among 80 Gram-negative isolates tested, 4 were meropenem-resistant; 3 of these were confirmed carbapenemase producers (NDM, KPC, OXA-48) using mCIM and Carba 5 tests. One isolate showed non-carbapenemase resistance. These findings highlight the rising burden of MDR and carbapenemase-producing pathogens in ocular infections.
Conclusion: The high prevalence of carbapenemase-producing MDR ocular pathogens, predominantly carrying bla NDM, highlights the urgent need for routine molecular screening and antibiotic stewardship in ophthalmic care. Rapid detection using the Carba 5 test facilitates timely and targeted therapy, essential for preserving vision and controlling antimicrobial resistance in ocular infections.
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Mohit Kumar
Ph.D Scholar, Department of Microbiology, Index Medical College, Hospital & Research Centre, Malwanchal University Indore, Madhya Pradesh, India.
Munesh Kumar Sharma
Professor and Head, Department of Microbiology, Amaltas Institute of Medical Sciences Dewas, Madhya Pradesh, India.