Antibiotic Resistance Genes Among Carbapenem-resistant Enterobacterales

Background: The global spread of carbapenem-resistant Enterobacterales (CRE) inflicts a severe threat to human health. The CRE infections have resulted in an increased mortality rate in hospitals and other health-care settings worldwide. In this study, the antibioticresistance pattern and prevalence...

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Published inInfection and drug resistance Vol. 14; p. 3485
Main Authors Tunyong, Witawat, Pumirat, Pornpan, Chaicumpa, Wanpen, Arsheewa, Weewan, Santajit, Sirijan, Indrawattana, Nitaya, Kong-ngoen, Thida, Sookrung, Nitat
Format Journal Article
LanguageEnglish
Published Dove Medical Press Limited 31.08.2021
Subjects
Antibacterial agents
Bacteria
Bacterial pneumonia
DNA sequencing
Drug resistance in microorganisms
Genes
Health aspects
Hospitals
Nucleotide sequencing
Pneumonia
Sulbactam
Thailand
Thailand
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Summary:Background: The global spread of carbapenem-resistant Enterobacterales (CRE) inflicts a severe threat to human health. The CRE infections have resulted in an increased mortality rate in hospitals and other health-care settings worldwide. In this study, the antibioticresistance pattern and prevalence of carbapenemase-encoding genes among CRE isolated from patients of one hospital in Thailand were investigated. Methods: By using conventional biochemical tests, we identified and isolated all species of Enterobacterales from the clinical samples kept at Prapokklao Hospital, Chanthaburi, Thailand, which were collected during 2016-2017. Multidrug-resistant (MDR) bacteria were determined by disc diffusion method and minimum inhibitory concentration (MIC) test strips. Carbapenemase genes were detected by PCR and confirmed by Sanger sequencing. Results: Klebsiella pneumoniae complex, Escherichia coli, and Enterobacter spp. were isolated from the specimens. Of 9,564 isolated Enterobacterales, 282 were multidrug-resistance (MDR). The MIC test strips revealed that the MDR CRE were resistant to ertapenem (92.9%) and meropenem (81.3%). All these isolates carried carbapenemase-coding genes, including [bla.sub.NDM] (90%) and [bla.sub.IMP] (71%), the two most commonly found genes among CRE strains. There were 39.2% of the isolates that carried a combination of [bla.sub.NDM]-[bla.sub.IMP] and 22.6% carried combined [bla.sub.NDM]-[bla.sub.IMP-blaOXA-48]-like genes. Conclusion: This study demonstrates a significantly high prevalence of CRE isolates with the MDR phenotypes. A minority of the isolates carried a single carbapenem- resistant gene, while the majority harbored multiple genes in combination. Regular monitoring of MDR CRE and characterization of their drug resistance are important for guiding treatment, intervention and control of the CRE spread and outbreak in a health-care setting. Keywords: carbapenemase, CRE, drug resistant, Enterobacterales, nosocomial infections
ISSN:1178-6973
1178-6973