The prevalence of carbapenem-resistant Enterobacteriacea is on the rise
worldwide, posing a major public health threat as well as a serious concern for infection
control management. The accurate identification and reporting of carbapenemase
producing Enterobacteriacea (CPE) will aid infection control practitioners in preventing
the spread of these multidrug- resistant isolates. Objectives: This study aimed to detect
the prevalence of CPE in Benha university hospitals and to confirm the presence of k.
Pneumoniae carbapenemase (KPC) and New Delhi Metallo-β- Lactamase (NDM) in
Enterobacteriacea. Methodology: This study was conducted on 100 Enterobacteriacea
strains collected from patients admitted to Benha University Hospitals. The isolated
Enterobacteriacea strains were screened for CPE by chromID CARBA agar with species
identification by using API 20 E test strips as a biochemical identification system. KPC
and NDM carbapenemases detection was confirmed phenotypically by Mast Disc ID
carbapenemase detection set (MDI) and genotypically by multiplex PCR. Results: Out of
100 Enterobacteriacea isolates, 40 strains (40 %) are carbapenemase producers and
27strains of them (67.5 %) are carrying genes responsible for carbapenem resistant.
Twenty six strains (65%) are carrying KPC gene and only one k. Pneumoniae strain
(2.5%) is carrying NDM-1 gene for MβL production. MDI detected 60% of KPC and
25% of MβL producers with high sensitivity (92.6 %) in comparison to PCR. Intensive
Care Unit patients harbored most of carbapenem-resistant isolates with the highest
percentage of carbapenemases genes in k. Pneumoniae. Conclusion: Emergence of CPE
pathogens in our setting create an important challenge for clinicians and hospital
epidemiologists with the possibility of outbreak eruption by these difficult-to-treat
pathogens, in the future. |
