A study on carbapenem-resistant Enterobacterales at a tertiary care hospital in north India.

Abstract

Introduction: Antimicrobial-resistant organisms pose a significant threats to human health and are are a contributing factor to high  mortality and morbidity in the affected patients.Resistance to Carbapenems is a challenge  as the treatment options for Carbapenem resistant bacteria are very limited.This study was carried out to determinethe prevalence of Carbapenem resistant enterobacterales (CRE), their distribution in different samples  and their  antibiotic sensitivity pattern at a tertiary care hospital  in North India.

 Materials and Methods:  This prospective study was carried out in the Department of Microbiology over 6 months (Jan 2022-June 2022). Samples such as respiratory samples, pus, body fluids, blood, and other samples collected from patients admitted in different wards were processed for the presence of Enterobacterales by conventional methods (for respiratory samples, pus, body fluids, and other samples) and automated BacT Alert system (for blood) and antimicrobial susceptibility testing was performed using kirby bauer disc diffusion method.

Results: Out of 6227 samples collected and processed from different samples and different areas of our hospital during the study period of 6 months, 471 isolates were found to be enterobacterales. Out of these, 160 isolates were carbapenem-resistant Enterobacterales (CRE), showing a prevalence of 33.9% among enterobacterales.   The highest percentage of CRE was isolated from surgical Intensive care unit (48.1%). Antibiotic usage and the presence of comorbid condition was found in 71.8% and 97.5% of CRE cases respectively. A hospital stay of ≥7 days was present in a maximum number of CRE cases. A major number of CRE isolates were from pus specimen (60%). The most common bacteria isolated was Klebsiella pneumoniae(47.5%). 97% isolates were MDR.

Conclusion: The prevalence of infections caused by carbapenem-resistant pathogens in our hospital was 33.9% and their presence in every area of the hospital was found. The high prevalence of carbapenem-resistant Enterobacterales and the occurrence of multidrug resistance in such organisms poses a threat and emphasizes on the early detection, isolation, and contact precaution of CRE patients to prevent their  dissemination.