A retrospective study on molecular epidemiology trends of carbapenem resistant Enterobacteriaceae in a teaching hospital in Malaysia

Kong, Zhi Xian and Karunakaran, Rina N. and Jabar, Kartini Abdul and Ponnampalavanar, Sasheela and Chong, Chun Wie and Teh, Cindy Shuan Ju (2022) A retrospective study on molecular epidemiology trends of carbapenem resistant Enterobacteriaceae in a teaching hospital in Malaysia. PeerJ, 10. ISSN 2167-8359, DOI https://doi.org/10.7717/peerj.12830.

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Background: Carbapenem resistant Enterobacteriaceae (CRE) has rapidly disseminated worldwide and has become a global threat to the healthcare system due to its resistance towards ``last line'' antibiotics. This study aimed to investigate the prevalence of CRE and the resistance mechanism as well as the risk factors associated with in-hospital mortality. Methods: A total of 168 CRE strains isolated from a tertiary teaching hospital from 2014-2015 were included in this study. The presence of carbapenemase genes and minimum inhibitory concentration of imipenem, meropenem and colistin were investigated. All carbapenem-resistant Klebsiella pneumoniae (K. pneumoniae) strains were characterised by PFGE. The risk factors of patients infected by CRE associated with in-hospital mortality were determined statistically. Results: The predominant CRE species isolated was K. pneumoniae. The carbapenemases detected were blaOXA-48, blaOXA-232, blaVIM and blaNDM of which blaOXA-48 was the predominant carbapenemase detected among 168 CRE strains. A total of 40 CRE strains harboured two different carbapenemase genes. A total of seven clusters and 48 pulsotypes were identified among 140 CRKp strains. A predominant pulsotype responsible for the transmission from 2014 to 2015 was identified. Univariate statistical analysis identified that the period between CRE isolation and start of appropriate therapy of more than 3 days was statistically associated with in-hospital mortality.

Item Type: Article
Funders: Ministry of Education, Malaysia [Grant No: FRGS/1/2018/SKK11/UM/02/4], International Society of Infectious Diseases [Grant No: IF016-2015]
Uncontrolled Keywords: Carbapenem resistant Enterobacteriaceae; Carbapenemase; Pulse-field gel electrophoresis; Porins; Epidemiology
Subjects: Q Science > Q Science (General)
T Technology > T Technology (General)
Divisions: Faculty of Medicine
Depositing User: Ms. Juhaida Abd Rahim
Date Deposited: 09 Aug 2022 06:57
Last Modified: 09 Aug 2022 06:57
URI: http://eprints.um.edu.my/id/eprint/33342

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