Colonization of intestinal microbiota with carbapenemase-producing Enterobacteriaceae in paediatric intensive care...

Area of Science:

• Microbiology
• Infectious Diseases
• Public Health

Background:

• Carbapenemase-producing Enterobacteriaceae (CPE) pose a significant threat for invasive infections in vulnerable patient populations.
• Colonization with CPE increases the risk of endogenous infections, particularly in intensive care unit (ICU) settings.

Purpose of the Study:

• To determine the prevalence of fecal colonization with CPE among children admitted to Cairo University pediatric ICUs.
• To characterize the carbapenemase-producing Enterobacteriaceae isolates phenotypically and genotypically.

Main Methods:

• Rectal swabs from 100 children in pediatric ICUs were cultured, yielding 413 Enterobacteriaceae isolates.
• Carbapenem-resistant Enterobacteriaceae (CRE) were screened using ChromID™ CARBA agar, followed by disk diffusion and Modified Hodge tests.
• Multiplex PCR was employed to detect specific carbapenemase genes, including blaOXA-48, blaKPC, blaNDM-1, blaVIM, and blaIMP.

Main Results:

• Out of 413 isolates, 100 were identified as CRE, indicating a 24% prevalence of carbapenem-resistant Enterobacteriaceae colonization.
• blaOXA-48 was the most prevalent carbapenemase gene, detected in 33% of CRE isolates, primarily in Klebsiella pneumoniae and Escherichia coli.
• blaNDM-1 was identified in 27% of CRE isolates, also predominantly in Klebsiella pneumoniae and Escherichia coli.

Conclusions:

• The study revealed a significant prevalence of carbapenem-resistant Enterobacteriaceae colonization in children within Cairo University pediatric ICUs.
• Carbapenemase genes were detected in 80% of CRE isolates, with blaOXA-48 being the dominant gene, underscoring the genetic diversity of resistance mechanisms.
• Implementing strict infection control measures and understanding colonization patterns are crucial to mitigate the spread of carbapenemases and prevent horizontal gene transfer.