An Important Public Health Problem "Carbapenem Resistant Enterobacteriaceae Frequency": An Example From A Training And Research Hospital

Abstract

Background: Carbapenem-resistant Enterobacterales (CRE) infections are a significant threat to public health due to the limited availability of antibiotics and the effect on mortality. This study was conducted retrospectively to determine the prevalence of CRE in a teaching and research hospital in Istanbul. Materials and Methods: In 2016, 2017 and in the first half of 2018 Klebsiella species were evaluated retrospectively in culture samples that were sent to Microbiology Laboratory in an educational hospital. The typing of Klebsiella species were performed with MALDITOF-MS device (Biomerieux, France). Imipenem, merapenem, ertapenem susceptibilities of the strains were evaluated with VITEC2 Compact (Biomerieux, France) according to EUCAST (European Committee on Antimicrobial Susceptibility Testing). If the strains were found to be resistant, the results were confirmed by the antibiotic gradient test. Results: In our study, 257 samples; Klebsiella oxytoca 9 (3.49%) and Klebsiella pneumoniae 248 (96.51%) were detected. 130 endotracheal aspirates, 57 wounds, 34 blood, 15 urine, 9 sputum, 3 catheters, 4 tissue biopsies, 2 mediastinum, 2 peritoneal fluid and 1 pleural fluid strains were identified. While none of the Klebsiella oxytoca strains were resistant to carbapenems, the percentages of Klebsiella pneumoniae resistance against imipenem, merapenem and ertapenem were found to be 23.29%, 16.94% and 29.44% respectively. Conclusion: The increasing problem of carbapenem-resistant (CR) Klebsiella pneumoniae in the last decade has been observed in our hospital for the last 2 years. CR strains often show increased resistance to other antibiotics and their treatment possibilities are limited. It increases the importance of controlling this factor. The application of effective infection control programs and the use of rational antibiotics are of great importance.