Abstract
The emergence and spread of Carbapenem-resistant Enterobacteriaceae (CRE) is seriously posing threats in effective healthcare delivery. The aim of this study was to ascertain the emergence of CRE at Chukwuemeka Odumegwu Ojukwu University Teaching Hospital (COOUTH) Awka. Biological samples were collected from 153 consenting patient from 5 clinics in the hospital. The isolates were identified using standard microbiological protocols. Susceptibility to meropenem was done using Kirby-Bauer disc diffusion method on Mueller Hinton Agar. A total of 153 patients were recruited in this study. About one half of those from rural, 63.64% from Sub-urban and 42.27% from urban areas had significant E. coli and Klebsiella spp infections. The male: female ratio of the Enterobacteriaceae infection was 1:1. Almost as much inpatient as outpatient study participants had the infections. The infections were observed mostly on participants with lower educational status. The unmarried individuals were most infected compared to their married counterparts. Enterobacteriaceae infection rate was 50.98%. Of this, 28.21% had CRE infection while the overall prevalence of the CRE in the studied population was 14.38% (22/153). This study shows that CRE is quickly emerging in both community and hospital environments. Klebsiella spp was the most common CRE in this hospital especially Klebsiella oxytoca. Hospitalization was a strong risk factor in the CRE infections. Rapid and accurate detection is critical for their effective management and control.
Highlights
Enterobacteriaceae are a large family of aerobic Gram-negative rods existing mostly as part of normal flora in the human and animal colons
The identified enterobacteriaceae were confirmed by biochemical methods while the confirmed isolates were tested for carbapenemase production using Meropenem (10 μg) disc
A total of 78 Escherichia coli and Klebsiella spp were isolated from clinical samples while the prevalence of Carbapenem resistance was 14.38% (22/153) in the hospital
Summary
Enterobacteriaceae are a large family of aerobic Gram-negative rods existing mostly as part of normal flora in the human and animal colons. Like other beta-lactams antibiotics, they act by binding to penicillin-binding proteins, thereby inhibiting the synthesis of bacterial cell wall They are primarily used in hospitalized patients. Extensively drug-resistant (XDR) and pandrug-resistant (PDR) organisms are rapidly emerging and spreading worldwide [3,4] and at a rate extremely faster than the development of new drug molecules. They have been implicated in community-acquired as well as hospital-acquired infection outbursts such that among the most important contemporary healthcare issues are the emergence and spread of antimicrobial-resistant infections [4,5]. That Carbapenem-resistant Enterobacteriaceae (CRE) infections are with us has been a global health challenge and constitutes much concern to public and private health services [6]
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