Epidemiology of carbapenemase producing Enterobacteriaceae in a general hospital
Journal Title: Journal of Microbiology and Infectious Diseases - Year 2015, Vol 5, Issue 2
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. J Microbiol Infect Dis 2015;5(2): 57-62 Key words: Enterobacteriaceae, carbapenemases, resistant organisms, carbapenems, epidemiology
Authors and Affiliations
Amina Kandeel
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