Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Microbiology and Immunology

The inadequate and uncontrolled use of carbapenems, which are often the last line for treating infections caused by ESBL-producing Enterobacteriaceae, led to the emergence and abrupt spread of carbapenem-resistant Enterobacteriaceae (CRE). Risk factors for CRE include; severity of illness, history of hospitalization or stay in an intensive care unit, prior antimicrobial use and immunosuppression. The aim of our study was to determine the prevalence of CRE intestinal colonization in patients on admission to Theodor Bilharz Research Institute (TBRI), to characterize the genotypic diversity of CRE in recovered isolates and to determine risk factors of intestinal colonization with CRE. One hundred rectal swabs were collected from patients on admission and cultured on CHROM ID CARBA SMART media. Identification and antibiotic susceptibility testing were done using VITEK2C compact system. Carbapenemase enzyme production was confirmed by Rapidec Carba NP test and multiplex PCR. Prevalence of CRE colonization was 28% giving a total of 36 isolates. Most of isolates were of species Escherichia coli (83.3%), followed by Klebsiella pneumoniae (13.9%) and finally Pluralibacter (2.8%). History of recent hospitalization within the previous 12 months as well as having antibiotic intake within the previous month revealed to be significant risk factors predisposing to CRE colonization

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