CARBAPENEM-RESISTANT AND METALLO- β -LACTAMASES PRODUCING ENTEROBACTERALES FROM CLINICAL SPECIMENS AT MAHAKALI PROVINCIAL HOSPITAL, FAR WESTERN NEPAL

Madan Singh Bohara; Supriya Sharma; Dwij Raj Bhatta

doi:10.3126/jist.v31i1.92267

Authors

Madan Singh Bohara Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu; Central Department of General Science, Far-Western University, Sudurpashchim https://orcid.org/0009-0004-2904-9534
Supriya Sharma Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Nepal https://orcid.org/0000-0002-0149-1732
Dwij Raj Bhatta Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu https://orcid.org/0000-0002-9845-3838

DOI:

https://doi.org/10.3126/jist.v31i1.92267

Keywords:

Carbapenem resistance, mCIM, eCIM, Enterobacterales, Far-Western Nepal

Abstract

The emergence of carbapenem-resistant Enterobacteriaceae (CRE) is a global health threat, yet data from Sudurpashchim Province, Nepal remains scarce. This study investigated the prevalence of carbapenemase and metallo-β-lactamase (MBL) production among Enterobacteriaceae in this underrepresented region. A hospital based cross sectional study was conducted at Mahakali Provincial Hospital from November 2024 to February 2026 among 385 Enterobacteriaceae isolates Phenotypic carbapenem resistance was determined by disc diffusion while carbapenemase and MBL production were confirmed using modified Carbapenem Inactivation Method (mCIM) and EDTA-modified CIM (eCIM), respectively. Multidrug resistance (MDR) was observed in 55.32% (213/385) of isolates. Phenotypic carbapenem resistance was detected in 3.90% (15/385) whereas 8.57% (33/385) were confirmed as carbapenemase producers by mCIM. MBL production was identified in 3.12% (12/385) of isolates. Statistical analysis revealed a significant association between MDR and all carbapenem resistance markers with all CRE and 91.67% of MBL producers exhibiting an MDR phenotype. This study identifies a significant reservoir of hidden carbapenemase production in Far-Western Nepal. Mandatory integration of low-cost phenotypic screening like mCIM is essential for effective antimicrobial stewardship in resource limited provincial settings.

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