Incidence of Carbapenem Resistant Enterobacteriaceae

Abstract

Objectives: To determine the incidence and antimicrobial sensitivity of carbapenem resistant Enterobacteriaceae (CRE).

Methods: This prospective descriptive study was carried out on Enterobacteriaceae specimens isolated from the patients during January 1, to December 31, 2011. The identification and antimicrobial susceptibility testing of Enterobacteriaceae isolates were determined using the automated MicroScan, Walkaway system. The modified Hodge test was used for confirmation of carbapenemase production of the isolates.

Results: Nine of the total 6,795 Enterobacteriaceae isolates produced carbapenemase enzyme, hence the incidence of CRE was 0.13%. The following strains were identified: Klebsiella pneumonia, Escherichia coli, Enterobacter cloacae and Citrobacter freundii. All the isolates were 100% resistant to ampicillin, cefotaxime, ceftriaxone, ceftazidime, cefepime, amoxicillin/calvulanic acid, ampicillin/salbactam and ertapenem. About 88.9% of the isolates were resistant to ciprofloxacin and piperacillin/tazobactam. The resistant to imipenem, meropenem and amikacin were found in 66.7%, 55.5% and 22.2% respectively. No resistant to colistin was observed.

Conclusion: The incidence of carbapenem resistant Enterobacteriaceae in the Faculty of Medicine Vajira Hospital was 0.13%. The presence of the multidrug resistance was an important public health problem. Continuing surveillance and effective infection control measures are recommended to limit the spread of these organisms.

Keywords: carbapenem resistant Enterobacteriaceae (CRE), Klebsiella pneumoniae carbapenemase (KPC), antimicrobial susceptibility testing