Carbapenemase-producing Enterobacterales in Prapokklao Hospital: Retrospective study in 2016 – 2018

Abstract

Currently, the problem of antimicrobial resistance in hospitalized patients is a worrying problem, specially in the case of Carbapenem-resistant Enterobacterales (CRE). The present work was a retrospective study of 191 unique strains of CRE which were found to be K. pneumoniae, E. coli and E. cloacae in 135 (70.7%), 44 (23.0%), 12 (6.3%) isolates, respectively. Of these, bla_NDM, bla_OXA-48-like, bla_IMP, bla_NDM with bla_OXA-48-like, bla_NDM with ampC and other genes were found in 86 (45.0%), 42 (22.0%), 30 (15.7%), 8 (4.2%), 7 (3.7%), 18 (9.4%) isolates, respectively. MIC50 and MIC90 of ertapenem and meropenem were 64 and 64 µg/mL for blaOXA-48-like-carrying isolates, 32, 64 and 8, 64 µg/mL for blaNDM-carrying isolates, and 4, 64 and 2, 64 µg/mL for blaIMP-carrying isolates respectively. The CRE strains were found in 123 (64.4%) males and 68 (35.6%) females, at over 60 years of age 112 (53.6%) and under 60 years of age 78 (40.8%), in inpatient wards, intensive care unit and in outpatients at 156 (81.7%), 34 (17.8%) and 1 (0.5%) patients, respectively. The most common specimens were from the respiratory tract, urinary tract, pus, blood and other specimens, in 73 (38.22%), 80 (41.9%), 16 (8.4%), 15 (7.9%), 7 (3.7%) isolates, respectively. In conclusion, the most common CRE were K. pneumoniae, bla_NDM, bla_OXA-48-likebla_IMP, respectively. The sensitivity of both ertapenem and meropenem at MIC₅₀และ MIC₉₀ in blaOXA-48 like was 64 mcg /mL. It is more common in inpatients and elderly patients.