Publication: Antibiotic resistance genes among carbapenem-resistant enterobacterales (Cre) isolates of prapokklao hospital, chanthaburi province, Thailand
Issued Date
2021-01-01
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ISSN
11786973
Other identifier(s)
2-s2.0-85115370048
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Mahidol University
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SCOPUS
Bibliographic Citation
Infection and Drug Resistance. Vol.14, (2021), 3485-3494
Suggested Citation
Witawat Tunyong, Weewan Arsheewa, Sirijan Santajit, Thida Kong-Ngoen, Pornpan Pumirat, Nitat Sookrung, Wanpen Chaicumpa, Nitaya Indrawattana Antibiotic resistance genes among carbapenem-resistant enterobacterales (Cre) isolates of prapokklao hospital, chanthaburi province, Thailand. Infection and Drug Resistance. Vol.14, (2021), 3485-3494. doi:10.2147/IDR.S328521 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/78611
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Title
Antibiotic resistance genes among carbapenem-resistant enterobacterales (Cre) isolates of prapokklao hospital, chanthaburi province, Thailand
Abstract
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 antibiotic-resistance 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-resis-tance (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 blaNDM (90%) and blaIMP (71%), the two most commonly found genes among CRE strains. There were 39.2% of the isolates that carried a combination of blaNDM-blaIMP and 22.6% carried combined blaNDM-blaIMP-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.