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B Maamar1, A A Messadi1, L Thabet1

  • 1Centre de Traumatologie et des Grands Brûlés, Ben Arous, Tunisie.

Annals of Burns and Fire Disasters
|April 22, 2020
PubMed
Summary
This summary is machine-generated.

Carbapenemase-producing Enterobacteriaceae (CPE) are a growing global threat. This study found a high prevalence of CPE in burn unit patients, with NDM genes being most common and colistin showing good in vitro activity.

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Area of Science:

  • Microbiology
  • Molecular Biology
  • Infectious Diseases

Context:

  • Carbapenemase-producing Enterobacteriaceae (CPE) represent a significant and increasing global health concern.
  • Burn units are particularly vulnerable to the emergence and spread of multidrug-resistant organisms due to patient susceptibility and environmental factors.

Purpose:

  • To determine the prevalence of CPE among hospitalized patients in a Burn Unit.
  • To characterize the microbiological and molecular features of isolated CPE strains.
  • To assess antibiotic resistance patterns and identify effective treatment options.

Summary:

  • A longitudinal study from January to June 2017 identified 42 CPE strains from 34 patients in a Burn Unit, with an overall Enterobacteriaceae prevalence of 14.43%.
  • Klebsiella pneumoniae and Proteus mirabilis were the most common species. The blaNDM gene was predominant (59%), followed by blaOXA-48 (33%), with 7% co-expression. The first case of P. stuartii carrying blaNDM in Tunisia was reported.

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  • High resistance rates were observed for third-generation cephalosporins (97%), gentamicin (98%), and norfloxacin (90%). Ertapenem, imipenem, and meropenem resistance were 83%, 57%, and 10%, respectively. Colistin (4% resistance) and fosfomycin (33% resistance) demonstrated the best in vitro activity.

    • Impact:

    • The findings highlight the high prevalence of CPE in burn patients, emphasizing the need for robust screening protocols and stringent hygiene measures.
    • Preserving the activity of last-resort antibiotics like colistin is crucial for managing CPE infections in vulnerable populations.
    • This research contributes to understanding CPE epidemiology and guiding antimicrobial stewardship in critical care settings.