Carbapenem resistant Enterobacteriaceae neonatal gut colonization: A future concern in healthcare settings Choudhury Debapriya Das1,*, Singh N P2, Rai Sumit3, Batra Prerna4, Manchanda Vikas5 1Assistant Professor, Dept. of Microbiology, D.Y. Patil Medial College, Navi Mumbai, Maharashtra 2Professor and HOD, Dept. of Microbiology, University College of Medical Sciences & GTB Hospital, New Delhi 3Associate Professor, Dept. of Microbiology, Super Speciality Paediatric Hospital & PG Teaching Institute, Noida, Uttar Pradesh 4Associate Professor, Dept. of Paediatrics, University College of Medical Sciences & GTB Hospital, New Delhi 5Associate Professor, Maulana Azad Medical College, Delhi, India *Corresponding Author: Email: debapriya.dmr@gmail.com
Online published on 14 January, 2019. Abstract Introduction Carbapenem-resistant Enterobacteriaceae (CRE) isolates are resistant to carbapenem and other beta-lactam drugs. Infections with these CREs have been reported in different age groups and are difficult to treat because of their resistant pattern and thus, they have become epidemiologically important. Materials and Methods Rectal swabs from 150 term/late preterm neonates (> 35 weeks) and 150 preterm neonates (< 35 weeks) were collected who were hospital delivered and admitted in NICU and likely to stay > 3 days. Three rectal swabs were taken; 1st within 24hrs of birth (day 0), 2nd on day 3 and 3rd before discharge (day 4–10). They were screened for CRE in stool/rectal swab according to CDC criteria. These were further confirmed by following CLSI guidelines (MHT) to observe the carbapenemases production and real-time PCR for blaNDM-1, blaIMP, blaVIM, blaKPC. Results A total of 8.7% (26/300) possible CREs were isolated in term/late preterm (15/26, 57.7%) and preterm neonates (11/26, 42.3%). Klebsiella pneumoniae was the commonest organism. In total, 22/26 (84.6%) possible CREs were MHT positive and rest 4 were MHT negative. The majority of MHT positive CREs were multidrug-resistant whereas MHT negative CREs was sensitive to tested carbapenem drugs. Carbapenemases genes (blaNDM-1=10, blaVIM=8, blaIMP=1, blaKPC=0) were identified in 19/26 of possible CREs, but multiple carbapenemases genes were not found. Conclusions In this study, neonates were colonized with CRE within their gut as early as 72 hours after birth. This can cause infection in the postnatal period and may lead to spread of CRE in the community. Top Keywords Carbapenem-Resistant Enterobacteriaceae, Neonatal Intensive care Unit, Modified Hodge Test. Top |