Detection of intestinal colonization by carbapenem-resistant Enterobacteriaceae among patients admitted to a tertiary care hospital in Egypt

Background The irrational use of carbapenems in the last years lead to the emergence of carbapenem-resistant Enterobacteriaceae (CRE). This study aimed at determining the prevalence of CRE intestinal carriage among admitted patients in a tertiary care hospital in Egypt, to characterize carbapenemase...

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Published in:Egyptian Journal of Medical Human Genetics 2022-04, Vol.23 (1), p.83-8
Main Authors: El-Defrawy, Inas, Gamal, Doaa, El-Gharbawy, Rania, El-Seidi, Eman, El-Dabaa, Ehab, Eissa, Somaya
Format: Article
Language:English
Subjects:
Antibiotics
Carbapenemase
Carbapenemases
Carbapenems
Colonization
Computer software industry
CRE
CRE bacteria
Enterobacteriaceae
Imipenem
Intestine
NDM
OXA-48
Patients
Risk factors
Risk groups
Statistical analysis
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Summary:Background The irrational use of carbapenems in the last years lead to the emergence of carbapenem-resistant Enterobacteriaceae (CRE). This study aimed at determining the prevalence of CRE intestinal carriage among admitted patients in a tertiary care hospital in Egypt, to characterize carbapenemase-producing genes and to identify possible risk factors of CRE colonization. One hundred rectal swabs were collected from patients within 48 h of hospital admission. Culture was done on chromogenic media and then identification and antibiotic susceptibility testing were done using Vitek 2 compact system. Carbapenemase production was confirmed by Rapidec Carba NP test and by multiplex PCR for bla.sub.OXA-48-like, bla.sub.NDM-like, bla.sub.VIM-like, bla.sub.IMP-like and bla.sub.KPC-like. Results A total number of 36 CRE isolates were recovered from 28 patients. Thus, the prevalence of CRE colonization was 28%. Escherichia coli (83%), followed by Klebsiella pneumoniae (17%) were the main species. History of recent hospitalization and prior antibiotic intake were statistically significant risk factors predisposing to CRE colonization. Rapidec Carba NP gave positive results in 29/36 CRE isolates, whereas seven isolates gave negative results; six of them harbored bla.sub.OXA-48-like. Overall, the bla.sub.OXA-48-like was detected in 24/36 (66.7%), followed by bla.sub.NDM-like in 11/36 (30.6%) and lastly bla.sub.VIM-like in 1/36 (2.8%). Conclusions Our findings confirm that CRE colonization is disseminating in our healthcare facility, a fact that should be considered as possible pathogens causing infections in high risk patients. Strict infection control measures should be applied to all CRE carriers at hospital admission and a proper antimicrobial stewardship program should be followed in clinical settings.
ISSN:1110-8630
2090-2441
DOI:10.1186/s43042-022-00295-9