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<p>Gram-negative bacteria are major contributors to intensive care unit (ICU)-acquired infections, further complicated by biofilm formation, multidrug resistance (MDR), and carbapenemase production. This study, conducted in Uttar Pradesh, India (2022–2023), assessed the distribution, antibacterial resistance profiles, biofilm formation, and risk factors associated with carbapenemase-producing organisms (CPOs) in ICU patients. A total of 321&#xa0;g-negative bacteria (GNB) isolates were recovered from 311 clinical samples. Bacterial identification, antibacterial susceptibility testing, biofilm detection, and PCR-based carbapenemase gene analysis were performed. Clinical and demographic variables were evaluated to determine factors associated with CPO infections and outcomes. The predominant pathogens were <i>Pseudomonas aeruginosa</i> 109 (34%), <i>Klebsiella pneumoniae</i> 77 (24%), and <i>Escherichia coli</i> 53 (16.5%). High resistance rates were observed for β-lactams and fluoroquinolones, whereas carbapenems, aminoglycosides, and polymyxins remained largely effective. Biofilm formation was noted in <i>Acinetobacter baumannii</i> 23 (74.2%), <i>K. pneumoniae</i> 56 (72.7%), <i>P. aeruginosa</i> 74 (67.9%), and <i>E. coli</i> 34 (64.1%). The most prevalent carbapenemase genes were <i>blaNDM-1</i> 28 (45.9%), <i>blaOXA-48</i> 14 (23%), and <i>blaVIM</i> 7 (11.5%), with co-existence in 13 isolates (21.3%). CPO infections occurred in 61/311 patients (19.6%). Significant risk factors included male sex (42; 68.9%), age &gt; 40&#xa0;years (43; 70.5%), ICU stay &gt; 7&#xa0;days (46; 75.4%), urinary catheterization (41; 67.2%), venous catheterization (37; 60.7%), and mechanical ventilation (40; 65.6%). Mortality was higher in CPO-infected patients (23; 37.7%) than in non-CPO cases (52; 20.8%). Biofilm formation and carbapenemase genes are key drivers of MDR-GNB in ICUs. CPO infections are strongly linked to invasive device use and increased mortality, underscoring the need for robust antibacterial stewardship and infection control practices.</p>

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Distribution, antibacterial resistance, biofilm formation, and risk factors associated with carbapenemase-producing gram-negative bacteria in ICU patients

  • 期刊论文

  • 发表日期：

    2026年3月25日

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  • Mohd Saleem,
  • Mohd Shahid Khan,
  • Irfan Ahmad,
  • Malak Yahia Qattan,
  • Mohammed Salem Alharbi

摘要

Gram-negative bacteria are major contributors to intensive care unit (ICU)-acquired infections, further complicated by biofilm formation, multidrug resistance (MDR), and carbapenemase production. This study, conducted in Uttar Pradesh, India (2022–2023), assessed the distribution, antibacterial resistance profiles, biofilm formation, and risk factors associated with carbapenemase-producing organisms (CPOs) in ICU patients. A total of 321 g-negative bacteria (GNB) isolates were recovered from 311 clinical samples. Bacterial identification, antibacterial susceptibility testing, biofilm detection, and PCR-based carbapenemase gene analysis were performed. Clinical and demographic variables were evaluated to determine factors associated with CPO infections and outcomes. The predominant pathogens were Pseudomonas aeruginosa 109 (34%), Klebsiella pneumoniae 77 (24%), and Escherichia coli 53 (16.5%). High resistance rates were observed for β-lactams and fluoroquinolones, whereas carbapenems, aminoglycosides, and polymyxins remained largely effective. Biofilm formation was noted in Acinetobacter baumannii 23 (74.2%), K. pneumoniae 56 (72.7%), P. aeruginosa 74 (67.9%), and E. coli 34 (64.1%). The most prevalent carbapenemase genes were blaNDM-1 28 (45.9%), blaOXA-48 14 (23%), and blaVIM 7 (11.5%), with co-existence in 13 isolates (21.3%). CPO infections occurred in 61/311 patients (19.6%). Significant risk factors included male sex (42; 68.9%), age > 40 years (43; 70.5%), ICU stay > 7 days (46; 75.4%), urinary catheterization (41; 67.2%), venous catheterization (37; 60.7%), and mechanical ventilation (40; 65.6%). Mortality was higher in CPO-infected patients (23; 37.7%) than in non-CPO cases (52; 20.8%). Biofilm formation and carbapenemase genes are key drivers of MDR-GNB in ICUs. CPO infections are strongly linked to invasive device use and increased mortality, underscoring the need for robust antibacterial stewardship and infection control practices.