Prevalence of Carbapenem Resistant Enterobacteriaceae and Carbapenemase Genes in Lerdsin Hospital
DOI:
https://doi.org/10.14456/jdms.2023.18Keywords:
Prevalence, Carbapenem resistant Enterobacteriaceae, CRE, Carbapenemase geneAbstract
Background: Carbapenem Resistant Enterobacteriaceae (CRE) is a global problem including in Thailand. Mostprevalence studies are conducted at the phenotype level because studies at the genotype level have many limitations, especially in terms of cost. Objective: This study aimed to determine the prevalence of CRE and carbapenemaseproducing genes to assess the situation of Lerdsin Hospital. Method: Routine reports from 2017 to 2021 were analyzedfor the prevalent study. 48 isolates of Klebsiella pneumoniae (K. pneumoniae) and Escherichia coli (E. coli) fromfour groups of specimens: blood, urine, sputum, and sterile site that showed carbapenem resistance by microbrothdilution, were tested for blaKPC, blaNDM, blaOXA-48, blaVIMand blaIMP by multiplex PCR technique. Result: The resultsshowed that carbapenem-resistant K. pneumoniae and carbapenem-resistant E. coli had a rising trend. In 2017, thenumber of cases of carbapenem-resistant K. pneumoniae was 31.42% and carbapenem-resistant E. coli was 1.39%.It then increased to 38.83% and 3.55%, respectively in 2021. The highest prevalence was found at the intensive careunit and mostly found in sputum and followed by urine, blood, and sterile site. Multiplex PCR for detecting five majorcarbapenemase-producing genes was identified from 48 samples, of which 31 isolates were K. pneumoniae and 17isolates were E. coli. There were 20 isolates (41.7%) found in target genes: 12 isolates from K. pneumoniae and 8isolates from E. coli, blaNDM and blaOXA-48 were found in 10 isolates equally. The blaNDM gene was most found in E. coli from the sterile site, and the blaOXA-48 gene was most found in K. pneumoniae from urine. Conclusion: This studyshows a rising trend of CRE in Lerdsin Hospital. This CRE problem is not only caused by carbapenemase-producinggenes but may also be caused by other mechanisms or a combination of several mechanisms.
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