Evaluation of Faecal Carriage of Carbapenem-Resistant Enterobacteriaceae among Patients Admitted in an Intensive Care Unit of a Tertiary Care Hospital

Abstract

BACKGROUND Association of man with the microbial world have found to be co-existed since old ages. Out of these microbial agents, some bacteria which provide a symbiotic balance, leading to a protective and stabilizing effect on the body, are known as resident microbes. On the other hand, some bacteria which invade and grow in man’s tissues causing diseases, damages and sometimes death, are known as pathogenic bacteria. This study was performed to evaluate the carbapenem resistance pattern among the patients admitted to an ICU in the Accident and Emergency departments. METHODS Rectal/ perianal swabs were taken from patients who were admitted to the intensive care unit (ICU) of the accident and emergency department. Swabs were collected first on the day of admission, then on day 4, and thereafter weekly while they were admitted in the ICU to monitor the resistance pattern among ICU patients. RESULTS A total of 100 rectal/ perianal swabs were collected from 89 patients on different days of admission to the ICU. Out of these 89 patients, CRE, i.e. E. coli or Klebsiella species were obtained from 35 patients. Now from these 35 patients, the samples were collected on day 1, day 4, and day 7 of admission. Then, out of these 35 patients, carbapenem-resistant Klebsiella pneumoniae and E. coli isolates were recovered from 35 (39.3%) patients i.e. Klebsiella pneumoniae isolates from fifteen patients and carbapenem-resistant E. coli isolates from twenty patients. CONCLUSIONS Carbapenems were earlier considered as the last-resort antibiotics for the treatment of infections caused by multidrug-resistant gram-negative bacteria. But, due to non-judicious use of carbapenems in clinical settings, the emergence of carbapenem-resistant organisms has become a big threat of concern to human health.