Carbapenem resistant Enterobacteriaceae neonatal gut colonization: A future concern in healthcare settings

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Original Article

Author Details : Debapriya Das Choudhury, N P Singh, Sumit Rai, Prerna Batra, Vikas Manchanda

Volume : 5, Issue : 3, Year : 2018

Article Page : 348-354

https://doi.org/10.18231/2394-5478.2018.0073

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Abstract

Introduction: Carbapenem-resistant Enterobacteriaceae (CRE) isolates are resistant to carbapenem and other beta-lactam drugs. Infections with these CREs have been reported in different age groups and are difficult to treat because of their resistant pattern and thus, they have become epidemiologically important.
Materials and Methods: Rectal swabs from 150 term/ late preterm neonates (> 35 weeks) and 150 preterm neonates (< 35> 3 days. Three rectal swabs were taken; 1^st within 24hrs of birth (day 0), 2^nd on day 3 and 3^rd before discharge (day 4-10). They were screened for CRE in stool/rectal swab according to CDC criteria. These were further confirmed by following CLSI guidelines (MHT) to observe the carbapenemases production and real-time PCR for bla_NDM-1, bla_IMP, bla_VIM, bla_KPC.
Results: A total of 8.7% (26/300) possible CREs were isolated in term/late preterm (15/26, 57.7%) and preterm neonates (11/26, 42.3%). Klebsiella pneumoniae was the commonest organism. In total, 22/26 (84.6%) possible CREs were MHT positive and rest 4 were MHT negative. The majority of MHT positive CREs were multidrug-resistant whereas MHT negative CREs was sensitive to tested carbapenem drugs. Carbapenemases genes (bla_NDM-1=10, bla_VIM=8, bla_IMP=1, bla_KPC=0) were identified in 19/26 of possible CREs, but multiple carbapenemases genes were not found.
Conclusions: In this study, neonates were colonized with CRE within their gut as early as 72 hours after birth. This can cause infection in the postnatal period and may lead to spread of CRE in the community.

Keywords: Carbapenem-Resistant Enterobacteriaceae, Neonatal Intensive care Unit, Modified Hodge Test.

How to cite : Choudhury D D, Singh N P, Rai S, Batra P, Manchanda V, Carbapenem resistant Enterobacteriaceae neonatal gut colonization: A future concern in healthcare settings. Indian J Microbiol Res 2018;5(3):348-354

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