Epidemiology and clinical characteristics of patients with carbapenem-resistant enterobacterales infections: experience from a large tertiary care center in a developing country

BMC Infectious Diseases

Research

Adham Abu Taha¹  Sa’ed H. Zyoud²  Suha Sholi³  Banan M. Aiesh⁴  Ali Sabateen⁴  Farah Qandeel⁵  Yazan Maali⁵  Siwar Omarya⁵  Shatha Abu Taha⁵ 

[1] Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, An-Najah National University, 44839, Nablus, Palestine;Department of Pathology, An-Najah National University Hospital, 44839, Nablus, Palestine;Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, 44839, Nablus, Palestine;Poison Control and Drug Information Center (PCDIC), College of Medicine and Health Sciences, An-Najah National University, 44839, Nablus, Palestine;Clinical Research Center, An-Najah National University Hospital, 44839, Nablus, Palestine;Department of General Surgery, An-Najah National University Hospital, 44839, Nablus, Palestine;Department of Infection Prevention and Control, An-Najah National University Hospital, 44839, Nablus, Palestine;Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, 44839, Nablus, Palestine;

关键词: Carbapenem resistant Enterobacterales;    Resistance;    Meropenem;    Escherichia coli;    Klebsiella pneumoniae;   

DOI  :  10.1186/s12879-023-08643-9

 received in 2023-05-13, accepted in 2023-09-25,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundCarbapenem-resistant Enterobacterales (CREs) are a significant source of healthcare-associated infections. These bacteria are difficult to treat and have a high mortality rate due to high rates of antibiotic resistance. These pathogens are also linked to major outbreaks in healthcare institutions especially those with limited resources in infection prevention and control (IPC). Therefore, our study aimed to describe the epidemiology and clinical characteristics of patients with carbapenem-resistant Enterobacteriaceae in a referral hospital in a developing country.MethodsThis was a retrospective cross-sectional study that included 218 patients admitted to An-Najah National University Hospital between January 1, 2021, and May 31, 2022. The target population was all patients with CRE infection or colonization in the hospital setting.ResultsOf the 218 patients, 135 had CR-Klebsiella pneumoniae (61.9%), and 83 had CR-Escherichia coli (38.1%). Of these, 135 were male (61.9%) and 83 were female (38.1%), with a median age of 51 years (interquartile range 24–64). Malignancy was a common comorbidity in 36.7% of the patients. Approximately 18.3% of CRE patients were obtained from patients upon admission to the emergency department, the largest percentage among departments. Most CRE pathogens were isolated from rectal swabs, accounting for 61.3%. Among the 218 patients, colistin was the most widely used antimicrobial agent (13.3%). CR- E. coli showed resistance to amikacin in 23.8% of the pathogens tested and 85.7% for trimethoprim/sulfamethoxazole compared to CR- K. pneumonia, for which the resistance to trimethoprim/sulfamethoxazole was 74.1%, while for amikacin it was 64.2%. Regarding meropenem minimum inhibitory concentration, 85.7% of CR- E. coli were greater than 16 µg/mL compared to 84% of CR- K. pneumonia isolates.ConclusionThis study found that CRE is frequently reported in this tertiary care setting, implying the presence of selective pressure and transmission associated with healthcare setting. The antibiotics tested showed a variety of resistance rates, with CR-K. pneumoniae being more prevalent than CR-E. coli, and exhibiting an extremely high resistance pattern to the available therapeutic options.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023