A retrospective study on molecular epidemiology trends of carbapenem resistant Enterobacteriaceae in a teaching hospital in Malaysia
Document Type
Article
Publication Date
2-22-2022
Abstract
Background: Carbapenem resistant Enterobacteriaceae (CRE) has rapidly disseminated worldwide and has become a global threat to the healthcare system due to its resistance towards ``last line'' antibiotics. This study aimed to investigate the prevalence of CRE and the resistance mechanism as well as the risk factors associated with in-hospital mortality. Methods: A total of 168 CRE strains isolated from a tertiary teaching hospital from 2014-2015 were included in this study. The presence of carbapenemase genes and minimum inhibitory concentration of imipenem, meropenem and colistin were investigated. All carbapenem-resistant Klebsiella pneumoniae (K. pneumoniae) strains were characterised by PFGE. The risk factors of patients infected by CRE associated with in-hospital mortality were determined statistically. Results: The predominant CRE species isolated was K. pneumoniae. The carbapenemases detected were blaOXA-48, blaOXA-232, blaVIM and blaNDM of which blaOXA-48 was the predominant carbapenemase detected among 168 CRE strains. A total of 40 CRE strains harboured two different carbapenemase genes. A total of seven clusters and 48 pulsotypes were identified among 140 CRKp strains. A predominant pulsotype responsible for the transmission from 2014 to 2015 was identified. Univariate statistical analysis identified that the period between CRE isolation and start of appropriate therapy of more than 3 days was statistically associated with in-hospital mortality.
Keywords
Carbapenem resistant Enterobacteriaceae, Carbapenemase, Pulse-field gel electrophoresis, Porins, Epidemiology
Divisions
fac_med
Funders
Ministry of Education, Malaysia [Grant No: FRGS/1/2018/SKK11/UM/02/4],International Society of Infectious Diseases [Grant No: IF016-2015]
Publication Title
PeerJ
Volume
10
Publisher
PeerJ Inc
Publisher Location
341-345 OLD ST, THIRD FLR, LONDON, EC1V 9LL, ENGLAND