Clinical and molecular epidemiology of carbapenem-resistant Enterobacteriaceae (c r e) single institutional experience Egypt. Clinical and molecular epidemiology of carbapenem-resistant Enterobacteriaceae (CRE) : (Record no. 177036)
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| fixed length control field | 08390nam a22004571i 4500 |
| 003 - CONTROL NUMBER IDENTIFIER | |
| control field | EG-GICUC |
| 005 - أخر تعامل مع التسجيلة | |
| control field | 20251225183100.0 |
| 008 - FIXED-LENGTH DATA ELEMENTS--GENERAL INFORMATION | |
| fixed length control field | 251225s2025 ua a|||frm||| 000 0 eng d |
| 040 ## - CATALOGING SOURCE | |
| Original cataloguing agency | EG-GICUC |
| Language of cataloging | eng |
| Transcribing agency | EG-GICUC |
| Modifying agency | EG-GICUC |
| Description conventions | rda |
| 041 0# - LANGUAGE CODE | |
| Language code of text/sound track or separate title | eng |
| Language code of summary or abstract | eng |
| -- | ara |
| 049 ## - Acquisition Source | |
| Acquisition Source | Deposit |
| 082 04 - DEWEY DECIMAL CLASSIFICATION NUMBER | |
| Classification number | 618.92994 |
| 092 ## - LOCALLY ASSIGNED DEWEY CALL NUMBER (OCLC) | |
| Classification number | 618.92994 |
| Edition number | 21 |
| 097 ## - Degree | |
| Degree | Ph.D |
| 099 ## - LOCAL FREE-TEXT CALL NUMBER (OCLC) | |
| Local Call Number | Cai01.19.05.Ph.D.2025.Sa.C |
| 100 0# - MAIN ENTRY--PERSONAL NAME | |
| Authority record control number or standard number | Sally Mahfouz Abd-Elnaby, |
| Preparation | preparation. |
| 245 10 - TITLE STATEMENT | |
| Title | Clinical and molecular epidemiology of carbapenem-resistant Enterobacteriaceae (c r e) single institutional experience Egypt. Clinical and molecular epidemiology of carbapenem-resistant Enterobacteriaceae (CRE) : |
| Remainder of title | single institutional experience, Egypt / |
| Statement of responsibility, etc. | by Sally M ahfouz Abd-Elnaby ; Supervision Prof. Dr. Lobna Mohammed Shalaby, Prof. Dr. Youssef M adney Saed, Prof. Dr. Mervat Elanany, Dr. Nora Atef Gouda. |
| 246 15 - VARYING FORM OF TITLE | |
| Title proper/short title | علم الاوبئة السريرية والجزيئية للبكتريا المعوية المقاومة للكاربابينيم تجربة مؤسسية واحدة بمصر |
| 264 #0 - PRODUCTION, PUBLICATION, DISTRIBUTION, MANUFACTURE, AND COPYRIGHT NOTICE | |
| Date of production, publication, distribution, manufacture, or copyright notice | 2025. |
| 300 ## - PHYSICAL DESCRIPTION | |
| Extent | 102 pages : |
| Other physical details | illustrations ; |
| Dimensions | 25 cm. + |
| Accompanying material | CD. |
| 336 ## - CONTENT TYPE | |
| Content type term | text |
| Source | rda content |
| 337 ## - MEDIA TYPE | |
| Media type term | Unmediated |
| Source | rdamedia |
| 338 ## - CARRIER TYPE | |
| Carrier type term | volume |
| Source | rdacarrier |
| 502 ## - DISSERTATION NOTE | |
| Dissertation note | Thesis (Ph.D)-Cairo University, 2025. |
| 504 ## - BIBLIOGRAPHY, ETC. NOTE | |
| Bibliography, etc. note | Bibliography: pages 85-102. |
| 520 #3 - SUMMARY, ETC. | |
| Summary, etc. | Background: The rapid worldwide spread of carbapenem-resistant Enterobacteriaceae (CRE) <br/>constitutes a major challenge. CRE carrying additional resistance genes to multiple antibiotic <br/>classes has created a generation of organisms nearly resistant to all available therapies. CRE <br/>infections are associated with significant morbidity and mortality worldwide. This study aims <br/>to define the clinical burden of CRE bloodstream infections (BSI), investigate predictors of <br/>poor outcomes and risk factors for acquiring CRE BSI, and describe their phenotypic and <br/>genotypic characteristics. <br/>Methods: This prospective study included Children under 18 years of age with positive blood <br/>culture for an Enterobacteriaceae (carbapenem-resistant phenotype [CRE] or carbapenem-<br/>VHQVLWLYHSKHQRW\SH>&6(@DWDFKLOGUHQ¶VFDQFHUKRVSLWDOLQ(J\SW±2021) with adopting <br/>antimicrobial stewardship program goals and introduction of PCR-based method (Cepheid <br/>XpertCarba-R assay) which is developed for detecting carbapenemase genes with the <br/>availability of results within one hour which can allow for rapid time to start active treatment <br/>in less than 48h. <br/>Results: The study focused on pediatric patients with positive blood cultures for <br/>Enterobacteriaceae, specifically those with either carbapenem-resistant (CRE) or carbapenem-<br/>sensitive (CSE) phenotypes. The participants were categorized into three groups: the first group <br/>included 186 patients with CRE-positive blood cultures, the second group comprised 188 <br/>patients with CSE-positive blood cultures, and the final group served as a control with 383 <br/>participants. Among the CRE patients, 83% had hematological malignancies, while 17% had <br/>solid tumors, with acute myeloid leukemia being the most prevalent hematological malignancy. <br/>The primary risk factors for acquiring carbapenem-resistant Enterobacteriaceae (CRE), as <br/>opposed to carbapenem-sensitive Enterobacteriaceae (CSE), include prolonged and severe <br/>neutropenia (absolute neutrophil count (ANC) below 100), prior exposure to beta-lactam/beta-<br/>lactamase inhibitors, recent hospitalizations, invasive procedures within the last 30 days, <br/>admissions to intensive care units, and a history of colonization with CRE. Escherichia coli <br/>was the most frequently isolated pathogen, accounting for 65% of cases, followed by Klebsiella <br/>pneumoniae at 31%. The documented sites of infection included pneumonia (37%), typhlitis <br/>(17%), skin and soft tissue infections (48%), and urinary tract infections (11%). Among the <br/>CRE patients, 57 exhibited aminoglycoside resistance (30.6%), while quinolone resistance was <br/>identified in 147 patients (79.0%). Additionally, colistin resistance was observed in 9 CRE <br/>patients (4.8%). The Genotypic profile for CRE in our study reported that class B (71%) with <br/>NDM reported in 126/186 (67%) and VIM 8/186 (4%) was the most common carbanamase <br/>followed by Oxa-48 in 110/186 (59%) of patients while KPC enzyme reported only in <br/>7/186(3.7%). Time to start active antibiotics were initiated within 48 hours for 89% of the <br/>patients, with a clinical cure observed in 67% of cases. Microbiological clearance occurred in <br/>less than 7 days for 62 % of patients. Sepsis related to CRE necessitated ICU admission for <br/>(26%). The 30-day mortality rate was reported at 31 out of 186 patients (16%). In a multivariate <br/>analysis of mortality predictors among patients with carbapenem-resistant Enterobacteriaceae <br/>(CRE), several factors were identified to elevate the risk of death significantly. These included <br/>a central venous catheter infection, extended hospital stays following infection, prolonged <br/>neutropenia after bacteremia, isolation of Klebsiella pneumonia as the causative pathogen, and <br/>the presence of the KPC and NDM genes as carbapenemase producers. <br/>Conclusion: CRE-BSI is a major threat among pediatric cancer patients in limited-resource <br/>countries and is considered a barrier against better outcomes. Antimicrobial stewardship <br/>through routine screening for colonization detection and Rapid diagnosis by using gene expert <br/>with rapid time to start adequate active antibiotics treatment is associated with improvement of <br/>outcome and decreasing mortality. |
| 520 #3 - SUMMARY, ETC. | |
| Summary, etc. | الانتشار السريع فى جميع أنحاء العالم للبكتريا المعوية المقاومة للكاربابنيم يشكل تحديا كبيرا . تحمل هذه البكتريا جينات مقاومة اضافية لفئات المضادات الحيوية المتعددة تسببت فى وجود أجيال من الكائنات الحية مقاومة تقريبا لكافة المضادات الحيوية المتاحة. و من المعروف ان الاصابة بهذه البكتريا مرتبطة بأمراض و نسبة وفيات عالية . الهدف من هذه الدراسة هو التحقيق من عوامل الخطر المسببة للاصابة بالبكتريا المعوية المقاومة للكاربابنيم و تحديد تنبؤات الوفيات فى الاطفال نتيجة الاصابة بالبكتريا المعوية المقاومة للكاربابنيم و كذلك تحديد الانماط الجينية المهيمنة للبكتريا المعوية المقاومة للكاربابنيم. للاجابة على الاسئلة المذكورة أعلاه سوف نقوم بتنفيذ دراسة رصدية تحليلية فى مستشفى سرطان الاطفال 57357 على مدى عامين. تشمل الدراسة الاطفال اقل من 18سنة من كلا الجنسين و المصابين بالبكتريا المعوية المقاومة للكاربابنيم و تحديد عوامل الخطر و تحديد تنبؤات الوفيات عند األطفال المصابين بعدوى مجرى الدم و الناجمة عن الاصابة بالبكتريا المعوية المقاومة للكاربابنيم مما سيؤدى الى تدخلات من شأنها أن تقلل من ظهور مسببات المقاومة و سوف توجه الباحثين و العلماء الى وضع استراتيجيات وقائية فعالة والتى قد تحد من انتشار هذه المسببات |
| 530 ## - ADDITIONAL PHYSICAL FORM AVAILABLE NOTE | |
| Issues CD | Issues also as CD. |
| 546 ## - LANGUAGE NOTE | |
| Text Language | Text in English and abstract in Arabic & English. |
| 650 #0 - SUBJECT ADDED ENTRY--TOPICAL TERM | |
| Topical term or geographic name entry element | Tumors in children |
| 650 #0 - SUBJECT ADDED ENTRY--TOPICAL TERM | |
| Topical term or geographic name entry element | الأورام عند الأطفال |
| 653 #1 - INDEX TERM--UNCONTROLLED | |
| Uncontrolled term | CRE |
| -- | Risk factors |
| -- | carbapenemase |
| 700 0# - ADDED ENTRY--PERSONAL NAME | |
| Personal name | Lobna Mohammed Shalaby |
| Relator term | thesis advisor. |
| 700 0# - ADDED ENTRY--PERSONAL NAME | |
| Personal name | Youssef M adney Saed, |
| Relator term | thesis advisor. |
| 700 0# - ADDED ENTRY--PERSONAL NAME | |
| Personal name | Mervat Elanany |
| Relator term | thesis advisor. |
| 700 0# - ADDED ENTRY--PERSONAL NAME | |
| Personal name | Nora Atef Gouda |
| Relator term | thesis advisor. |
| 900 ## - Thesis Information | |
| Grant date | 01-01-2025 |
| Supervisory body | Lobna Mohammed Shalaby |
| -- | Youssef Madney Saed |
| -- | Mervat Elanany |
| -- | Nora Atef Gouda. |
| Universities | Cairo University |
| Faculties | National Cancer Institute |
| Department | Department of Pediatric Oncology |
| 905 ## - Cataloger and Reviser Names | |
| Cataloger Name | Shimaa |
| 942 ## - ADDED ENTRY ELEMENTS (KOHA) | |
| Source of classification or shelving scheme | Dewey Decimal Classification |
| Koha item type | Thesis |
| Edition | 21 |
| Suppress in OPAC | No |
| Source of classification or shelving scheme | Home library | Current library | Date acquired | Inventory number | Full call number | Barcode | Date last seen | Effective from | Koha item type |
|---|---|---|---|---|---|---|---|---|---|
| Dewey Decimal Classification | المكتبة المركزبة الجديدة - جامعة القاهرة | قاعة الرسائل الجامعية - الدور الاول | 25.12.2025 | 92922 | Cai01.19.05.Ph.D.2025.Sa.C | 01010110092922000 | 25.12.2025 | 25.12.2025 | Thesis |