Prevalence of Carbapenem Resistant Enterobacterales at a Tertiary Care Hospital

Abstract

Background: Carbapenem-resistant Enterobacterales (CRE) have emerged as a major public health concern owing to their increasing prevalence, limited therapeutic options, and association with high morbidity and mortality. The rapid dissemination of carbapenemase-producing organisms has significantly challenged the management of healthcare-associated infections worldwide.

Aim: To determine the prevalence of Carbapenem-resistant Enterobacterales among clinical isolates obtained from patients attending a tertiary care hospital.

Materials and Methods: A prospective observational study was conducted in the Department of Microbiology of a tertiary care hospital from July 2023 to December 2023. Clinical specimens including urine, pus, swabs, blood, sputum, cerebrospinal fluid, pleural fluid, and other body fluids received for culture and antimicrobial susceptibility testing were included. Enterobacterales were isolated and identified using conventional microbiological methods. Antimicrobial susceptibility testing was performed by the Kirby–Bauer disc diffusion method according to the Clinical and Laboratory Standards Institute (CLSI) guidelines.

Results: A total of 306 Enterobacterales isolates were recovered during the study period, of which 133 (43.5%) were carbapenem-resistant. Escherichia coli was the predominant organism isolated (162/306) followed by Klebsiella pneumoniae (48/306). CRE were most commonly seen in Escherichia coli (74 isolates, 45.6%), most frequently isolated from urine specimens (59%) and hospitalized patients (48%). Among the carbapenem-resistant isolates, more resistance towards  Imipenem was observed compared to Meropenem.

Conclusion: The high proportion of CRE observed in the present study highlights the growing burden of antimicrobial resistance in tertiary healthcare settings. Continuous microbiological surveillance, strict infection prevention measures, and implementation of antimicrobial stewardship programmes are essential to limit the emergence and spread of CRE.