Epidemiology of carbapenemase producing Enterobacteriaceae in a general hospital

Abstract

Objective: Detect the presence of carbapenemases producing Enterobacteriaceae (CPE) and associated epidemiological, microbiological, and clinical characteristics of patients in our hospital Methods: During 15 months period, all non duplicate Enterobacteriaceae isolates with reduced susceptibility to carbapenem detected by MicroScan WalkAway system and confirmed by E test were collected. These suspected isolates were further screened by modified Hodge test and carbapenemase inhibition discs to identify CPE. Results: Out of 54 suspected Enterobacteriaceae isolates, 44 (88.5%) isolates were either extended spectrum beta-lactamases (ESBLs) or AmpC producers with porin loss whereas 10 isolates (18.5%) were confirmed to produce carbapenemase representing (0.74%) of the total Enterobacteriaceae. Among these 10 isolates, 6 were OXA 48 producers and 2 isolates were class B and class A each. Six out of the 10 CPE were detected in ICU and specimen source was tracheal aspirate in 5 CPE isolates. All CPE isolates were sensitive to colistin and all but one to tigecycline. All patients had history of previous antibiotic exposure and hospital stays for more than 5 days. Conclusion: Although CPE is not the main cause of carbapenem resistance in Enterobacteriaceae in our setting, its emergence there represents a serious infection control and therapeutic challenge. This mandates its early detection using MHT and carbapenemase inhibition tests together with strict infection control measures to limit its spread.

Prevalence and characterization of carbapenem-resistant Klebsiella pneumoniae isolated from intensive care units of Mansoura University hospitals

“…The high trend of CRKP in the current study could be attributed to the frequent use of carbapenems as an empiric therapy in ICUs at our institution, as well as lack of implementation of antimicrobial stewardship program. Our study subjects were ICUadmitted patients, since it was documented in previous studies that ICU stay was a major risk factor for CRKP acquisition [26]. In this study, sputum samples were the predominant sources of CRKP.…”

Multidrug-resistant and Extensively Drug-resistant Enterobacteriaceae: Prevalence, Treatments, and Outcomes: A Retrospective Cohort Study

“…(28) In this study, the prevalence of CPE was around 6.2%, which is higher than that reported in other studies. (29)(30)(31)(32)(33) This could be due to the high number of MDR-GNB infections observed in the study sample.…”

Characterization of Carbapenem-Resistant K. Pneumoniae Isolated from Intensive Care Units of Zagazig University Hospitals

“…Prior research indicated that ICU admission was a substantial risk factor for developing CRKP [ 21 ]. The participants in this study were individuals who had been admitted to the ICU.…”