Open AccessEmergence of Carbapenem-Resistant Enterobacteriaceae in a Tertiary Care Hospital in Southern Thailand†
Author(s) -
Prerit Upadhyaya Aryal,
Benjamas Thamjarungwong,
Kamonnut Singkhamanan,
Paramee Thongsuksai,
Natnicha Ingviya,
Varaporn Laohaprertthisan,
Rungtip Darayon,
Mingkwan Yingkajorn
Publication year - 2020
Publication title -
walailak journal of science and technology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.146
H-Index - 15
eISSN - 2228-835X
pISSN - 1686-3933
DOI - 10.48048/wjst.2020.10729
Subject(s) - citrobacter freundii , enterobacter cloacae , klebsiella pneumoniae , microbiology and biotechnology , biology , amikacin , enterobacter aerogenes , carbapenem , enterobacteriaceae , antimicrobial , escherichia coli , antibiotics , gene , biochemistry
Carbapenem-resistant Enterobacteriaceae (CRE) is emerging as a major problem in healthcare settings globally, including Thailand, due to limited therapeutic options. We reported the detection, antimicrobial susceptibility profiles, and the presence of carbapenemase genes of CRE isolates obtained from Songklanagarind Hospital between July 2012 and June 2015. A total of 273 non-duplicated CRE isolates was recovered from 248 patients. The predominant organism was Klebsiella pneumoniae (183 [67.0 %]), followed by Escherichia coli (38 [13.9 %]). The susceptibility to 13 antibiotics was performed by disk diffusion assay. Most of the CRE isolates remained susceptible to amikacin. Minimum inhibitory concentrations (MIC) of carbapenems were determined by E-test. The MIC50 and MIC90 were varied among genera and species. Multiplex PCRs for the carbapenemase genes blaIMP, blaVIM, blaOXA-48, blaNDM-1, blaKPC, and blaGES were performed. One hundred and seventy-eight out of these 273 CRE isolates (65.2 %) harbored either single or multiple carbapenemase genes. One hundred and fifty nine isolates harbored the blaNDM-1 gene (113 K. pneumoniae, 25 E. coli, 17 E. cloacae, 2 Citrobacter freundii, 1 Enterobacter aerogenes, and 1 Pantoea agglomerans), 7 isolates carried blaIMP (4 K. pneumoniae, 2 C. freundii, and 1 E. cloacae), 7 isolates possessed blaOXA-48 (1 K. pneumoniae, 5 E. coli, and 1 E. aerogenes), whereas 3 and 2 isolates harbored blaNDM-1 and blaIMP (2 K. pneumoniae and 1 E. cloacae) and blaNDM-1 and blaOXA-48 (1 E. coli and 1 E. cloacae), respectively. In conclusion, this study revealed the detection of CRE, with the majority of K. pneumoniae harboring blaNDM-1 in this setting.