Colonization of intestinal microbiota with carbapenemase-producing Enterobacteriaceae in paediatric intensive care units in Cairo, Egypt

Abstract

Background and study aims: Colonized patients with carbapenamase producing Enterobacteriaceae (CPE) are vulnerable to invasive infections from their endogenous flora. We aimed to assess faecal colonization with (CPE) among children admitted to Cairo University paediatric intensive care units (ICUs). The phenotypic and genotypic characterizations of carbapenemase-producing Enterobacteriaceae were also studied.

Patients and methods: A total of 413 Enterobacteriaceae isolates have been isolated from cultured rectal swabs of 100 children. All swabs were inoculated on ChromID™ CARBA agar to screen for carbapenem resistant Enterobacteriaceae (CRE). Disk diffusion method, Modified Hodge test (MHT) and further genotypic detection of carbapenemases genes (bla_OXA-48, bla_KPC and bla_NDM-1, bla_VIM and bla_IMP) by multiplex PCR were done.

Results: Out of 413 Enterobacteriaceae isolates; 100 isolates were defined as CRE. Bla_OXA-48 was detected in (33%); Escherichia coli (n = 11), Klebsiella oxytoca (n = 3) and Klebsiella pneumoniae (n = 19), while (27%) carried bla_NDM-1Escherichia coli (n = 7), and Klebsiella pneumoniae (n = 20).

Conclusion: Prevalence of carbapenem resistant Enterobacteriaceae was 24%, various genes of carbapenemases were detected in 80% of carbapenem resistant Enterobacteriaceae with dominance of bla_OXA-48. Understanding the colonization status of our patients with strict infection control measures can reduce the risk of horizontal gene transfer of carbapenemases.

Keywords: Carbapenem producing Enterobacteriaceae; Carbapenem resistant Enterobacteriaceae; bla(IMP); bla(KPC); bla(NDM-1); bla(OXA-48); bla(VIM).