CHARACTERIZATION OF MOLECULAR DRUG RESISTANCE IN BACTERIAL ISOLATES FROM CLABSI CASES IN A TERTIARY CARE HOSPITAL JAIPUR, RAJASTHAN

Abstract

Objective: Central Line-Associated Bloodstream Infection (CLABSI) is a major healthcare-associated infection associated with increased morbidity, mortality, and rising antimicrobial resistance. This study aimed to determine the microbial profile of CLABSI and characterize molecular mechanisms of antimicrobial resistance among bacterial isolates recovered from patients admitted to a tertiary care hospital in Jaipur, Rajasthan. Methods: A prospective observational study was conducted from May 2024 to Aug 2025 at Jaipur National University Institute for Medical Sciences & Research Centre, Jaipur. Blood culture samples from clinically suspected CLABSI patients were processed using standard microbiological techniques. Isolates were identified by conventional biochemical methods, and antimicrobial susceptibility testing was performed using the Kirby–Bauer disk diffusion method according to CLSI guidelines. Multidrug-resistant (MDR), extensively drug-resistant (XDR), and pan-drug resistant (PDR) phenotypes were determined. Resistance genes including mecA, blaKPC, blaNDM, blaOXA-48, blaVIM, and blaIMP were detected using “Multiplex real-time PCR (qPCR)”. Results: A total of 125 microbiologically confirmed CLABSI cases were analyzed. Males accounted for 57.6% of cases, and the most affected age group was 41–60 years (48.8%). MRSA (24.0%) and Acinetobacter species (20.0%) were the predominant pathogens. Enterobacteriaceae demonstrated the highest MDR (74.0%) and XDR (26.0%) rates. Molecular analysis identified blaNDM as the most prevalent resistance gene (26.7%), followed by mecA and blaIMP (20.0% each). Chills (34.8%) and bradycardia (25.5%) were the commonest clinical manifestations. Conclusion: The study revealed a substantial burden of multidrug-resistant and carbapenemase-producing pathogens among CLABSI cases. Integration of phenotypic susceptibility testing with molecular resistance profiling facilitates early detection of resistant pathogens and supports effective antimicrobial stewardship and infection control practices.