Abstract
Carbapenem-resistant Gram-negative bacilli (CR-GNB) has become a global threat. In hospital settings, the association of CR-GNB with ventilator-associated pneumonia (VAP) is a critical public health concern owing to their high resistance rate to most antibiotics. The present study aims to identify the frequency of carbapenem-resistance and to determine the rate of multidrug resistance (MDR), extensive drug resistance (XDR) and pan-drug resistance (PDR) among CR-GNB infections in VAP. Antimicrobial susceptibility testing was carried out using the disk diffusion method and the detection of carbapenemases was screened using the imipenem-E test and the modified carbapenem-inactivation method (mCIM). The isolates were verified by polymerase chain reaction (PCR) for the presence of blaNDM, blaSPM, blaVIM, blaIMP and blaGIM genes. 89.5%, 14%, 17.5%, 10.5%, 3.5% of isolates exhibited the presence of blaNDM, blaVIM, blaSPM, blaIMP and blaGIM, respectively. 76%, 17% and 7% of isolates were PDR, XDR, and MDR, respectively. Carbapenem-resistance genes were identified in a significant percentage and blaNDM was the most predominant gene. All isolates were highly resistant to most antibiotics. This health concern has proven to be a big challenge in developing countries such as Egypt, as it is associated with high morbidity, high mortality, and raised healthcare costs.
Highlights
Most seriously sick patients admitted to intensive care units (ICUs) reveal bad nutritional and general conditions, down immune status, prolonged hospital stays, and a history of invasive procedure and, they are vulnerable to increased propensity to infection [1]
The results revealed that the incidence of carbapenem-resistant K. pneumoniae (CRKP) was slightly higher in patients aged more than 50 years and increased with a longer hospital stay
The present study aims to identify the frequency of Carbapenem-resistant Gram-negative bacilli (CR-Gram-negative bacilli (GNB)) infections in ventilator-associated pneumonia (VAP) patients and to determine the frequency of multidrug resistance (MDR), XDR and pan-drug resistance (PDR) among CR-GNB causing VAP infections, especially since the rapid and precise detection of carbapenemase-producing isolates has proven difficult for laboratories and entails phenotypic and genotypic analysis
Summary
Regardless of the various complications related to mechanical ventilation (MV), it is lifesaving for most of ICUs patients. One of these complications is ventilator-associated pneumonia (VAP) which is a highly prevalent hospital-acquired infection (HAI) in ICUs. VAP is allied with lengthy hospital and ICU stays, prolonged MV time, expanded hospital expenses, enduring morbidity, and increasing mortality [2]. Antimicrobial resistance (AMR) is a worldwide health concern due to its correlation with high morbidity and mortality and raised healthcare costs [3]. The problem of AMR is increasing globally with the spread frequently striking healthcare settings due to the improper use of antimicrobials and inappropriate infection control practices. AMR risk is especially in low- and middle-income countries [4]
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