Risk factors, phenotypic and genotypic characterization of carpabenem resistant Enterobacteriaceae in Tanta University Hospitals, Egypt

Abstract

Carpabenem resistant Enterobacteriacae (CRE) is an increasing worldwide health problem with excess morbidity and mortality. So the aim of this work to study the risk factors, phenotypic and genotypic characters of CRE in our institute. Seventy five patients with hospital acquired infection were enrolled in this study. Identification and susceptibility testing were performed. The differentiation of the types of carbapenemases was done by inhibitor-based tests. The bla genes were detected by using the multiplex PCR. Out of 75 cases of Enterobacteriaceae, 47 (62.7%) CRE were detected. Cases of septicaemia and ventilator associated pneumonia with previous history of carbapenam intake especially in neonatal ICU were more risky for CRE. The overall detection rate in the CRE by modified hodge test (MHT) was 82.9%. By synergy combined disc tests, 47%, 19.1% were positive respectively for Klebsiella pneumonia carbapenemase (KPC) and metallo-β-lactamases (MBLs). By multiplex PCR, the most prevalent gene was bla KPC (22 ,46.8%), followed by blaVIM (10 , 21.3%) , blaOXA-48 (6 , 12.7%), bla KPC + blaOXA-48 (5, 10.6%), bla KPC + blaVIM (3 , 6.4%) while blaIMP and blaNDM genes were not detected. As the burden of carbapenem resistance in Egypt is increasing with limited treatment options. We suggest to develop antimicrobial stewardship in Tanta University Hospital together with governmental supervision to prevent the unrestricted anti microbial sales without prescriptions.

Detection and Characterization of Carbapenem resistant Gram-negative bacilli isolates recovered from hospitalized patients at Soba University Hospital, Sudan

“…This high frequency of MBL in Khartoum state is a result of the excessive use of meropenem in the treatment of patients associated with ESBL infections. This nding agrees with a study in Egypt, which reported that carbapenem resistance rate was 62.7% among Enterobacteriaceae (17). High rates of carbapenem resistance haves also been observed in Uganda in a study conducted by Okoche in 2015.…”

Detection of plasmid-mediated colistin resistance in carbapenem-resistant Escherichia coli and Klebsiella pneumoniae isolates in Suez Canal University Hospitals

“…This result shows accordance with El-Sweify et al [15] who reported carbapenem resistance in 44.3% of K. pneumoniae isolates in SCUHs. Higher results were detected by Melake et al [16] and Amer et al [17] as they reported 62.5% and 62.7% carbapenemresistance among K.pneumoniae and Enterobactereciae isolates. On the other hand, lower results of carbapenem resistance were also reported in different studies as Khare et al [18] and Okoche et al [19] reported 37.9% and 28.6% carbapenem resistance.…”

Prevalence and antibiotics susceptibility patterns of carbapenem resistant Enterobacteriaceae

“…(Ethiopia), Okoche D et al 13 (Uganda), Amer WH et al 14 (Egypt), Camara A et al 15 (Senegal), and Wartiti MA et al 16 (Morocco) which reported the prevalence of CRE were 15.2%, 12.12%, 28.6%, 62.7%, 5.1%, and 2.8% respectively. 11−16…”