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Prevalence of carbapenem resistant Enterobacteriaceae from a tertiary care hospital in Mumbai, India

Year 2013, Volume: 3 Issue: 04, 207 - 210, 01.12.2013
https://doi.org/10.5799/ahinjs.02.2013.04.0110

Abstract

Objective: The emergence of Carbapenem Resistant Enterobacteriaceae (CRE) in recent times has become a serious threat to public health due to the high mortality, potential dissemination rates and limited treatment options associated with these organisms. Thus, the present study was conducted in our tertiary care hospital in Mumbai, to retrospectively analyze the prevalence of CRE in the hospital. Methods: The study was carried out in the microbiology department of the tertiary care hospital over a period of 12 months. The samples tested were clinical samples from hospitalized and Out-Patient Department (OPD) patients sent to the department for microbiological testing. CRE isolates were identified using the Vitek 2- Compact system (BioMérieux, France). Results: A CRE prevalence rate of 12.26% was obtained from the study, from which the majority of the isolates were detected in urine samples (46%). Although most of the CRE isolates were detected in patient samples from the wards (42%) and the ICU (26%), a significant number of isolates was also detected from the OPD patients (19%). Conclusion: Thus, the study shows a significant rate of carbapenem resistance among Enterobacteriaceae isolated from hospitalized and OPD patients. This emphasizes the urgent need for CRE control at the hospital and community level, and to rationalize the use of antibiotics.

References

  • Zhanel GG, Wiebe R, Dilay L, et al. Comparative Review of the Carbapenems. Drugs 2007; 67:1027-1052.
  • Deshpande P, Rodrigues C, Shetty A, et al. New Delhi Metallo- b lactamase (NDM-1) in Enterobacteriaceae: Treatment op- tions with Carbapenems Compromised. J Assoc Physician India 2010; 58:147-149.
  • Datta P, Gupta V, Garg S, Chander J. Phenotypic method for differentiation of carbapenemases in Enterobacteriaceae: Study from north India. Indian J Pathol Microbiol 2012; 55:357-360.
  • CRE Toolkit, CDC-Guidance for Control of Carbapenem-resis- tant Enterobacteriaceae (CRE), 2012. http://www.cdc.gov/ hai/organisms/cre/cre-toolkit/f-level-prevention.html
  • Baldwin CM, Lyseng-Williamson KA, Keam SJ. Meropenem- A review of its use in the treatment of serious bacterial infec- tions. Drugs 2008; 68:803-838.
  • Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing: 22th infor- mational supplement. CLSI publication 2012; M100-S22. Clinical and Laboratory Standard Institute, Wayne, Pennsyl- vania.
  • Queenan AM, Bush K. Carbapenemases: the versatile β- Lac- tamases. Clinical Microbiology Reviews 2007;20:440-458.
  • Gupta E, Mohanty S, Sood S, et al. Emerging resistance to carbapenems in a tertiary care hospital in north India. Indian J Med Res 2006;124:95-98.
  • Wattal C, Goel N, Oberoi JK, et al. Surveillance of multidrug resistant organisms in tertiary care hospital in Delhi, India. J Assoc Physicians India 2010;58:32-36.
  • Nordmann P, Naas T, Poirel L. Global Spread of Carbapen- emase-producing Enterobacteriaceae. Emerg Infect Dis 2011;17:1791-1798.
  • Nagaraj S, Chandran SP, Shamanna P, Macaden R. Car- bapenem resistance among Escherichia coli and Klebsiella pneumoniaeae in a tertiary care hospital in south India. In- dian J Med Microbiol 2012;30:93-95.
  • Gupta N, Limbago BM, Patel JB, Kallen AJ. Carbapenem resistant Enterobacteriaceae: epidemiology and prevention. Healthcare Epidemiol 2011;53:60-67.
  • Woodford N, Eastaway AT, Ford M, et al. Comparison of BD Phoenix, Vitek 2, and microscan automated systems for detection and inference of mechanisms responsible for car- bapenem resistance in enterobacteriaceae. J Clin Microbiol 2010;48:2999-3002.

Prevalence of carbapenem resistant Enterobacteriaceae from a tertiary care hospital in Mumbai, India

Year 2013, Volume: 3 Issue: 04, 207 - 210, 01.12.2013
https://doi.org/10.5799/ahinjs.02.2013.04.0110

Abstract

Amaç: Karbapenem dirençli Enterobacteriaceae (CRE) enfeksiyonlarındaki artış halk sağlığı için önemli bir tehdit oluşturmaktadır çünkü bu bakterilerin enfeksiyonlarında kullanılabilecek sınırlı sayıda antibiyotik vardır ve mortalitesi yüksektir. Bu çalışma, Mumbai’de bulunan üçüncü basamak hizmet veren merkezimizde CRE prevalansını belirlemek amacıyla retrospektif olarak yapıldı.Yöntemler: Çalışma mikrobiyoloji bölümünde 12 aylık bir sürede yapıldı. Hem hastane kökenli hem de toplum kaynaklı örnekler çalışmaya dahil edilmiştir. Örnekler Vitek 2- Compact System (BioMérieux, France) ile analiz edildi.Bulgular: Çalışmamızda CRE sıklığı %12.26olarak bulunmuş olup örneklerin büyük bir kısmı idrar (% 46) örneklerinden elde edildi. Ancak CRE izole edilen örneklerin önemli bir kısmı yara örneklerinden (% 42) idi. Örneklerin % 26’sı yoğun bakım hastalarından izole edilirken %19’u da toplum kaynaklı örneklerden izole edildi. Sonuç: Çalışmamızda Enterobacteriaceae üyelerinin önemli bir kısmında karbapenem direnci olduğu gösterilmiştir. CRE kökenlerinin toplumda ve hastanede kontrol edilmesini sağlayacak önlemlere ve akılcı antibiyotik kullanımı sağlayacak tedbirlere ihtiyaç vardır

References

  • Zhanel GG, Wiebe R, Dilay L, et al. Comparative Review of the Carbapenems. Drugs 2007; 67:1027-1052.
  • Deshpande P, Rodrigues C, Shetty A, et al. New Delhi Metallo- b lactamase (NDM-1) in Enterobacteriaceae: Treatment op- tions with Carbapenems Compromised. J Assoc Physician India 2010; 58:147-149.
  • Datta P, Gupta V, Garg S, Chander J. Phenotypic method for differentiation of carbapenemases in Enterobacteriaceae: Study from north India. Indian J Pathol Microbiol 2012; 55:357-360.
  • CRE Toolkit, CDC-Guidance for Control of Carbapenem-resis- tant Enterobacteriaceae (CRE), 2012. http://www.cdc.gov/ hai/organisms/cre/cre-toolkit/f-level-prevention.html
  • Baldwin CM, Lyseng-Williamson KA, Keam SJ. Meropenem- A review of its use in the treatment of serious bacterial infec- tions. Drugs 2008; 68:803-838.
  • Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing: 22th infor- mational supplement. CLSI publication 2012; M100-S22. Clinical and Laboratory Standard Institute, Wayne, Pennsyl- vania.
  • Queenan AM, Bush K. Carbapenemases: the versatile β- Lac- tamases. Clinical Microbiology Reviews 2007;20:440-458.
  • Gupta E, Mohanty S, Sood S, et al. Emerging resistance to carbapenems in a tertiary care hospital in north India. Indian J Med Res 2006;124:95-98.
  • Wattal C, Goel N, Oberoi JK, et al. Surveillance of multidrug resistant organisms in tertiary care hospital in Delhi, India. J Assoc Physicians India 2010;58:32-36.
  • Nordmann P, Naas T, Poirel L. Global Spread of Carbapen- emase-producing Enterobacteriaceae. Emerg Infect Dis 2011;17:1791-1798.
  • Nagaraj S, Chandran SP, Shamanna P, Macaden R. Car- bapenem resistance among Escherichia coli and Klebsiella pneumoniaeae in a tertiary care hospital in south India. In- dian J Med Microbiol 2012;30:93-95.
  • Gupta N, Limbago BM, Patel JB, Kallen AJ. Carbapenem resistant Enterobacteriaceae: epidemiology and prevention. Healthcare Epidemiol 2011;53:60-67.
  • Woodford N, Eastaway AT, Ford M, et al. Comparison of BD Phoenix, Vitek 2, and microscan automated systems for detection and inference of mechanisms responsible for car- bapenem resistance in enterobacteriaceae. J Clin Microbiol 2010;48:2999-3002.
There are 13 citations in total.

Details

Primary Language English
Journal Section Brief Report
Authors

Pravin K Nair This is me

Michelle S Vaz This is me

Publication Date December 1, 2013
Published in Issue Year 2013 Volume: 3 Issue: 04

Cite

APA Nair, P. K., & Vaz, M. S. (2013). Prevalence of carbapenem resistant Enterobacteriaceae from a tertiary care hospital in Mumbai, India. Journal of Microbiology and Infectious Diseases, 3(04), 207-210. https://doi.org/10.5799/ahinjs.02.2013.04.0110
AMA Nair PK, Vaz MS. Prevalence of carbapenem resistant Enterobacteriaceae from a tertiary care hospital in Mumbai, India. J Microbil Infect Dis. December 2013;3(04):207-210. doi:10.5799/ahinjs.02.2013.04.0110
Chicago Nair, Pravin K, and Michelle S Vaz. “Prevalence of Carbapenem Resistant Enterobacteriaceae from a Tertiary Care Hospital in Mumbai, India”. Journal of Microbiology and Infectious Diseases 3, no. 04 (December 2013): 207-10. https://doi.org/10.5799/ahinjs.02.2013.04.0110.
EndNote Nair PK, Vaz MS (December 1, 2013) Prevalence of carbapenem resistant Enterobacteriaceae from a tertiary care hospital in Mumbai, India. Journal of Microbiology and Infectious Diseases 3 04 207–210.
IEEE P. K. Nair and M. S. Vaz, “Prevalence of carbapenem resistant Enterobacteriaceae from a tertiary care hospital in Mumbai, India”, J Microbil Infect Dis, vol. 3, no. 04, pp. 207–210, 2013, doi: 10.5799/ahinjs.02.2013.04.0110.
ISNAD Nair, Pravin K - Vaz, Michelle S. “Prevalence of Carbapenem Resistant Enterobacteriaceae from a Tertiary Care Hospital in Mumbai, India”. Journal of Microbiology and Infectious Diseases 3/04 (December 2013), 207-210. https://doi.org/10.5799/ahinjs.02.2013.04.0110.
JAMA Nair PK, Vaz MS. Prevalence of carbapenem resistant Enterobacteriaceae from a tertiary care hospital in Mumbai, India. J Microbil Infect Dis. 2013;3:207–210.
MLA Nair, Pravin K and Michelle S Vaz. “Prevalence of Carbapenem Resistant Enterobacteriaceae from a Tertiary Care Hospital in Mumbai, India”. Journal of Microbiology and Infectious Diseases, vol. 3, no. 04, 2013, pp. 207-10, doi:10.5799/ahinjs.02.2013.04.0110.
Vancouver Nair PK, Vaz MS. Prevalence of carbapenem resistant Enterobacteriaceae from a tertiary care hospital in Mumbai, India. J Microbil Infect Dis. 2013;3(04):207-10.

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