Carbapenem-Resistant Enterobacteriaceae in Cancer patients at National cancer institute, Thailand

Abstract

This study is retrospective research. The study's objective was to determine the prevalence, trends, and susceptibility patterns of CRE from cancer patients admitted to the National Cancer Institute between 2015 and 2019 by collecting the CRE data from all 1919 Enterobacteriaceae isolates, which are presented as CRE 169 isolates. Data were then analyzed using the prevalence, species, clinical departments, specimen types, and antimicrobial  susceptibility patterns. The results showed the prevalence of CRE from 2015 to 2019 were 3.0%, 9.4%, 10.8%, 16.6% and 4.3% respectively. In 2018, the CRE rate was statistically significantly increased to 6.52 times (OR 6.52, 95% CI 3.50-12.12,P<0.001). Moreover, the CRE rate between 2018 and 2019 was statistically significantly decreased in 2019 to 0.22 times (OR 0.22, 95% CI 0.2-12.12, P<0.001). Most two Enterobacteriaceae species were Klebsiella pneumonia53.8% and Escherichia coli 30.2%. Most two specimen types were urine at 63.3%, followed by sputum at 13.6%. The highest CRE isolates were found in the medical ward 60.4%, followed by the intensive care unit (ICU), 27.8%. The susceptibility pattern of CRE showed that Klebsiella pneumoniaewas susceptible to antimicrobial agents, which are Amikacin (43%), Gentamicin (57%), Doripenem (12%), Imipenem (26%), and Meropenem (13%).Escherichia coli was susceptible to antimicrobial agents, which are Amikacin (73%), Gentamicin (23%), Doripenem (57%), Imipenem (64%), and Meropenem (38%). This study revealed that CRE would be an important drug-resistant problem continuously in the National Cancer Institute.This study's results are useful in monitoring CRE resistance and supporting the doctor's decision to choose antibiotic treatment for infectious disease in cancer patients.