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Search for an optimal test algorithm and characteristic of carbapenemases in nosocomial strains
Lyubov Grigorievna Boronina1,2, E V Samatova2, M P Kukushkina2
1Urals State Medical University, chair of clinical laboratory diagnostics and bacteriology.
Abstract:
Resistance of representatives of the order Enterobacterales to ertapenem 12.1%. The highest frequency of insensitivity to this antimicrobial drug was noted among isolates of K. pneumoniae 29.4%. Among all enterobacterial isolates, resistance to imipenem and meropenem was 17.2% and 20%. The proportion of P. aeruginosa strains is 50.9% resistant to meropenem and imipenem, respectively, and 45% to doripenem. In turn, A. baumannii is resistant to meropenem - 66.6%, imipenem - 63.6%, doripenem - 83.3%. The following resistance genes were found in K. pneumoniae: NDM (n=2), KPC (n=10), OXA (n=1); in P. aeruginosa: VIM (n=8), NDM (n=1), OXA (n=1); A. baumannii OXA (n=1). At present, it is optimal to use molecular methods, in particular real-time PCR, to effectively monitor the distribution of carbapenemase producers, which tend to be widely distributed in a hospital setting. Molecular methods allow you to quickly get the result (during the working day) and give an adequate decision on antibiotic therapy.
Insights
High rates of carbapenem resistance are observed in Enterobacterales, Pseudomonas aeruginosa, and Acinetobacter baumannii. Molecular methods like real-time PCR are crucial for monitoring carbapenemase-producing organisms in hospitals.
Area of Science:
- Clinical Microbiology
- Infectious Diseases
- Antimicrobial Resistance
Background:
- Carbapenem antibiotics are critical for treating severe bacterial infections.
- Rising resistance to carbapenems poses a significant global health threat.
- Enterobacterales, Pseudomonas aeruginosa, and Acinetobacter baumannii are common causes of hospital-acquired infections.
Purpose of the Study:
- To determine the prevalence of carbapenem resistance in Enterobacterales, P. aeruginosa, and A. baumannii.
- To identify carbapenem resistance genes in clinical isolates.
- To evaluate the utility of molecular methods for rapid detection of carbapenemase producers.
Main Methods:
- Phenotypic antimicrobial susceptibility testing for ertapenem, imipenem, meropenem, and doripenem.
- Detection of carbapenemase genes (NDM, KPC, OXA, VIM) using molecular techniques.
- Real-time PCR for efficient monitoring of carbapenemase-producing bacteria.
Main Results:
- Ertapenem resistance in Enterobacterales was 12.1%, with K. pneumoniae showing 29.4% resistance.
- Resistance to imipenem and meropenem in Enterobacterales was 17.2% and 20%, respectively.
- High resistance rates were observed in P. aeruginosa (up to 50.9%) and A. baumannii (up to 83.3%) to carbapenems.
- Specific carbapenemase genes (NDM, KPC, OXA, VIM) were identified in the studied isolates.
Conclusions:
- Significant carbapenem resistance exists in key Gram-negative pathogens within hospital settings.
- Molecular methods, particularly real-time PCR, are effective for rapid identification and monitoring of carbapenemase-producing organisms.
- Timely detection facilitates informed antibiotic therapy decisions and infection control strategies.
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