Carriage prevalence of carbapenem-resistant Enterobacteriaceae in stool samples: A surveillance study

Abstract

Screening for carriage of CRE in stools of patients undergoing elective or emergency gastrointestinal surgical procedures, with haematological malignancies taking chemotherapy, or those planned for bone marrow transplantation can guide clinicians about gut colonisation of multidrug-resistant Enterobacteriaceae as these groups of patients are at risk of possible endogenous infection.

Rates of gastrointestinal tract colonization of carbapenem-resistant Enterobacteriaceae and Pseudomonas aeruginosa in hospitals in Saudi Arabia

“…This is low compared to other countries in the Middle East such as Morocco (13%), India (9.9%) and Pakistan (18.3%). However, it is comparable to studies in Korea (0.3%) [12] , [19] , [31] , [32] . In addition, the prevalence of colonization of CRPAE is 6.5%, which is lower than studies performed in Spain (12%) and higher than those in France (3.4%) [8] , [13] , [33] .…”

“…The treatment of these organisms became more difficult because of their production of extended-spectrum β-lactamases (ESBLs), such as bla CTX-M , plasmid-mediated AmpC (pAmpC) or overexpression of chromosomal amp C gene [6] , [7] , [8] , [9] , [10] . Carbapenems became the last source for treatment of such organisms, which in turn has led to the emergence of carbapenem resistance under antibiotic selective pressure [8] , [11] , [12] . The global spread of carbapenem-resistant, Gram-negative rods is significantly increasing [1] , [2] , [13] .…”

Carbapenem-resistant Enterobacteriaceae in the community: a scoping review

“…Although six studies (40.0%) provided no formal definition for CAI versus HAI, four of these considered their entire sample ‘community’ because all isolates were obtained from outpatients [40,41,43,45]. Two separate definitions of CAI were used in the remaining nine studies.…”

“…Urine was the primary source of isolates [16,25,35,37,40,43], followed by faeces [29,41,45,46], intra-abdominal fluid [38,39,44], blood [42] and respiratory culture [36]. For the five studies only including CRE, K. pneumoniae was the most common organism [16,25,36,37], except a US-based study that had a slightly higher percentage of Enterobacter spp.…”

“…One study excluded asymptomatic colonisation [35], whilst most of the studies did not mention colonisation or carriage as their entire sample had some type of active infection. Five studies tested specifically for colonisation, with three finding faecal carriage of CRE [29,45,46] ranging from 1.1% to 9.9% of the sample, and two not finding any CRE carriage [40,41]. One study reported a prevalence of 29% CRE colonisation or previous CRE infection prior to admission as a risk factor for subsequent CRE infection [37].…”