European Journal of Molecular & Clinical Medicine

Background:  Cholangitis represents a surgical emergency which has to be managed without delay. Surgical decompression and antimicrobial therapy remain the cornerstones of this condition. However, it is important to institute the correct antimicrobial therapy considering the local resistance patterns. The resistance β-lactams has become very rampant and is mostly due to Extended Spectrum Beta lactamases (ESBL). Carbapenems are commonly used in these cases but resistance to these agents by carbapenemase enzyme production is rising. Such strains are resistant to all β-lactams and might carry plasmid-borne genes for resistance to other classes of antibiotics as well. There are a limited number of agents available for treatment of such organisms

Background: The development of antibiotic resistance in bacterial isolates is the primary contributor to higher rates of death and morbidity across the globe. Carbapenems, which were originally thought to be useful but are now primarily rendered ineffective due to the appearance of carbapenemase, were once thought to be effective. The purpose of this study was to assess the in vitro efficacy of the modified Hodge test for the detection of carbapenemase synthesis in Gram-negative rods. (klebsiella pneumonia).
Materials and Methods: Between the months of September 2019 and December 2021, the research was carried out at the Department of Microbiology located at Govt General Hospital, Nalgonda. A total of 200 Gram-negative rods from a variety of clinical samples were collected. On the basis of disc diffusion, the researchers only included those isolates for the study that displayed intermediate or sensitive zones between 16 and 21 millimetres. After that, the Modified Hodge test was carried out on these isolated samples.
Results: The outcome of the study showed that out of a total of 300 isolates, 29 were positive for the synthesis of carbapenemase using the Modified Hodge test. The percentage of patients who had Klebsiella pneumonia that produced carbapenemase was 16 %.
Conclusion: The modified Hodge test is a straightforward procedure that can be carried out in a standard laboratory setting for the purpose of identifying carbapenemases in clinical isolates exhibiting either an intermediate or sensitive zone diameter on disc diffusion.It is of the utmost importance that any and all isolates that exhibit an intermediate or sensitive zone diameter on disc diffusion be tested for the production of carbapenemases using a modified version of the Hodge test, and these results be further verified by PCR.