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Antibiotic Resistance Genes Among Carbapenem-resistant Enterobacterales (CRE) Isolates of Prapokklao Hospital, Chanthaburi Province, Thailand
BACKGROUND: The global spread of carbapenem-resistant Enterobacterales (CRE) inflicts a severe threat to human health. The CRE infections have resulted in an increased mortality rate in hospitals and other health-care settings worldwide. In this study, the antibiotic-resistance pattern and prevalenc...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Dove
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8413090/ https://www.ncbi.nlm.nih.gov/pubmed/34511940 http://dx.doi.org/10.2147/IDR.S328521 |
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author | Tunyong, Witawat Arsheewa, Weewan Santajit, Sirijan Kong-ngoen, Thida Pumirat, Pornpan Sookrung, Nitat Chaicumpa, Wanpen Indrawattana, Nitaya |
author_facet | Tunyong, Witawat Arsheewa, Weewan Santajit, Sirijan Kong-ngoen, Thida Pumirat, Pornpan Sookrung, Nitat Chaicumpa, Wanpen Indrawattana, Nitaya |
author_sort | Tunyong, Witawat |
collection | PubMed |
description | BACKGROUND: The global spread of carbapenem-resistant Enterobacterales (CRE) inflicts a severe threat to human health. The CRE infections have resulted in an increased mortality rate in hospitals and other health-care settings worldwide. In this study, the antibiotic-resistance pattern and prevalence of carbapenemase-encoding genes among CRE isolated from patients of one hospital in Thailand were investigated. METHODS: By using conventional biochemical tests, we identified and isolated all species of Enterobacterales from the clinical samples kept at Prapokklao Hospital, Chanthaburi, Thailand, which were collected during 2016–2017. Multidrug-resistant (MDR) bacteria were determined by disc diffusion method and minimum inhibitory concentration (MIC) test strips. Carbapenemase genes were detected by PCR and confirmed by Sanger sequencing. RESULTS: Klebsiella pneumoniae complex, Escherichia coli, and Enterobacter spp. were isolated from the specimens. Of 9,564 isolated Enterobacterales, 282 were multidrug-resistance (MDR). The MIC test strips revealed that the MDR CRE were resistant to ertapenem (92.9%) and meropenem (81.3%). All these isolates carried carbapenemase-coding genes, including bla(NDM) (90%) and bla(IMP) (71%), the two most commonly found genes among CRE strains. There were 39.2% of the isolates that carried a combination of bla(NDM)-bla(IMP) and 22.6% carried combined bla(NDM)-bla(IMP)-bla(OXA-48-like) genes. CONCLUSION: This study demonstrates a significantly high prevalence of CRE isolates with the MDR phenotypes. A minority of the isolates carried a single carbapenem-resistant gene, while the majority harbored multiple genes in combination. Regular monitoring of MDR CRE and characterization of their drug resistance are important for guiding treatment, intervention and control of the CRE spread and outbreak in a health-care setting. |
format | Online Article Text |
id | pubmed-8413090 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Dove |
record_format | MEDLINE/PubMed |
spelling | pubmed-84130902021-09-09 Antibiotic Resistance Genes Among Carbapenem-resistant Enterobacterales (CRE) Isolates of Prapokklao Hospital, Chanthaburi Province, Thailand Tunyong, Witawat Arsheewa, Weewan Santajit, Sirijan Kong-ngoen, Thida Pumirat, Pornpan Sookrung, Nitat Chaicumpa, Wanpen Indrawattana, Nitaya Infect Drug Resist Original Research BACKGROUND: The global spread of carbapenem-resistant Enterobacterales (CRE) inflicts a severe threat to human health. The CRE infections have resulted in an increased mortality rate in hospitals and other health-care settings worldwide. In this study, the antibiotic-resistance pattern and prevalence of carbapenemase-encoding genes among CRE isolated from patients of one hospital in Thailand were investigated. METHODS: By using conventional biochemical tests, we identified and isolated all species of Enterobacterales from the clinical samples kept at Prapokklao Hospital, Chanthaburi, Thailand, which were collected during 2016–2017. Multidrug-resistant (MDR) bacteria were determined by disc diffusion method and minimum inhibitory concentration (MIC) test strips. Carbapenemase genes were detected by PCR and confirmed by Sanger sequencing. RESULTS: Klebsiella pneumoniae complex, Escherichia coli, and Enterobacter spp. were isolated from the specimens. Of 9,564 isolated Enterobacterales, 282 were multidrug-resistance (MDR). The MIC test strips revealed that the MDR CRE were resistant to ertapenem (92.9%) and meropenem (81.3%). All these isolates carried carbapenemase-coding genes, including bla(NDM) (90%) and bla(IMP) (71%), the two most commonly found genes among CRE strains. There were 39.2% of the isolates that carried a combination of bla(NDM)-bla(IMP) and 22.6% carried combined bla(NDM)-bla(IMP)-bla(OXA-48-like) genes. CONCLUSION: This study demonstrates a significantly high prevalence of CRE isolates with the MDR phenotypes. A minority of the isolates carried a single carbapenem-resistant gene, while the majority harbored multiple genes in combination. Regular monitoring of MDR CRE and characterization of their drug resistance are important for guiding treatment, intervention and control of the CRE spread and outbreak in a health-care setting. Dove 2021-08-29 /pmc/articles/PMC8413090/ /pubmed/34511940 http://dx.doi.org/10.2147/IDR.S328521 Text en © 2021 Tunyong et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). |
spellingShingle | Original Research Tunyong, Witawat Arsheewa, Weewan Santajit, Sirijan Kong-ngoen, Thida Pumirat, Pornpan Sookrung, Nitat Chaicumpa, Wanpen Indrawattana, Nitaya Antibiotic Resistance Genes Among Carbapenem-resistant Enterobacterales (CRE) Isolates of Prapokklao Hospital, Chanthaburi Province, Thailand |
title | Antibiotic Resistance Genes Among Carbapenem-resistant Enterobacterales (CRE) Isolates of Prapokklao Hospital, Chanthaburi Province, Thailand |
title_full | Antibiotic Resistance Genes Among Carbapenem-resistant Enterobacterales (CRE) Isolates of Prapokklao Hospital, Chanthaburi Province, Thailand |
title_fullStr | Antibiotic Resistance Genes Among Carbapenem-resistant Enterobacterales (CRE) Isolates of Prapokklao Hospital, Chanthaburi Province, Thailand |
title_full_unstemmed | Antibiotic Resistance Genes Among Carbapenem-resistant Enterobacterales (CRE) Isolates of Prapokklao Hospital, Chanthaburi Province, Thailand |
title_short | Antibiotic Resistance Genes Among Carbapenem-resistant Enterobacterales (CRE) Isolates of Prapokklao Hospital, Chanthaburi Province, Thailand |
title_sort | antibiotic resistance genes among carbapenem-resistant enterobacterales (cre) isolates of prapokklao hospital, chanthaburi province, thailand |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8413090/ https://www.ncbi.nlm.nih.gov/pubmed/34511940 http://dx.doi.org/10.2147/IDR.S328521 |
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