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

Theodor Bilharz Research Institute

Bibliographic Information

Authors: El-Defrawy I.; Gamal D.; El-Gharbawy R.; El-Seidi E.; El-Dabaa E.; Eissa S.

Journal: Egyptian Journal of Medical Human Genetics

Publisher: Springer Science and Business Media Deutschland GmbH

Publication Date: 19 April 2022

Volume / Issue: Volume 23 / Issue 1

Article No.: 83

ISSN: 11108630

DOI: 10.1186/s43042-022-00295-9

Scopus: View on Scopus

Document Type: Article

Access: All Open Access; Gold Open Access; Green Open Access

Authors and Affiliations

El-Defrawy I., Microbiology Department, Theodor Bilharz Research Institute (TBRI), PM Box 30 Imbaba, Giza, Egypt; Gamal D., Microbiology Department, Theodor Bilharz Research Institute (TBRI), PM Box 30 Imbaba, Giza, Egypt; El-Gharbawy R., Microbiology Department, Theodor Bilharz Research Institute (TBRI), PM Box 30 Imbaba, Giza, Egypt; El-Seidi E., Department of Medical Microbiology and Immunology, Faculty of Medicine, Cairo University, Giza, Egypt, Galala University, Suez, Egypt; El-Dabaa E., Biochemistry and Molecular Biology Department, Theodor Bilharz Research Institute (TBRI), PM Box 30, Imbaba, Giza, Egypt; Eissa S., Department of Medical Microbiology and Immunology, Faculty of Medicine, Cairo University, Giza, Egypt

Abstract

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 blaOXA-48-like, blaNDM-like, blaVIM-like, blaIMP-like and blaKPC-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 blaOXA-48-like. Overall, the blaOXA-48-like was detected in 24/36 (66.7%), followed by blaNDM-like in 11/36 (30.6%) and lastly blaVIM-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. © 2022, The Author(s).

Keywords

Carbapenemases; Colonization; CRE; Enterobacteriaceae; NDM; OXA-48; amikacin; ampicillin; aztreonam; carbapenem derivative; cefazolin; cefepime; ceftriaxone; ciprofloxacin; cotrimoxazole; ertapenem; gentamicin; imipenem; meropenem; moxifloxacin; nitrofurantoin; sultamicillin; tigecycline; tobramycin; adult; antibiotic sensitivity; antimicrobial stewardship; Article; bacterial colonization; bacterium detection; carbapenem-resistant Enterobacteriaceae; carbapenemase producing Enterobacteriaceae; clinical laboratory standard; comorbidity; controlled study; Egypt; Escherichia coli; female; health care facility; high risk patient; hospital admission; hospital patient; human; infection control; inhibitory concentration; intestine infection; Klebsiella pneumoniae; major clinical study; male; minimum inhibitory concentration; multiplex polymerase chain reaction; nonhuman; rectal swab; risk factor; tertiary care center

Citation Information

Scopus Citations: 11

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