Abstract
The prevalence of Carbapenem-resistant Enterobacteriaceae infection in a hospital setting is on the rise. Once infected, it is associated with increased morbidity as well as mortality. The common isolates of a Carbapenem-resistant Enterobacteriaceae infection is Klebsiella pneumoniae. In this case report, we discussed on a patient who is a Carbapenem-resistant Enterobacteriaceae carrier that underwent an open heart surgery in a government hospital in Johor Bahru, Malaysia. On the whole, our objectives were to identify risk factors that warrants a patient to be screened for Carbapenem-resistant Enterobacteriaceae infection and once a Carbapenem-resistant Enterobacteriaceae infected patient is detected, what are the measures that can be implemented to prevent and control spread of infection particularly in the intensive care unit setting.
Highlights
Carbapenem-resistant Enterobacteriaceae (CRE) infection is frequently being encountered within healthcare setting
In Malaysia the New Delhi metallo-ßlactamase-1 (NMD-1) gene was first detected in carbapenemresistant Klebsiella pneumoniae (CRKP) in 2010
According to Malaysia National Surveillance Antimicrobial Resistance (NSAR) which involves 41 participating hospitals, prevalence of CRKP has increased in the recent years, from 0.3% in 2011 to 2.8% in 2015
Summary
Carbapenem-resistant Enterobacteriaceae (CRE) infection is frequently being encountered within healthcare setting. They are associated with high morbidity, attributable mortality and increased hospital costs. In Malaysia the New Delhi metallo-ßlactamase-1 (NMD-1) gene was first detected in carbapenemresistant Klebsiella pneumoniae (CRKP) in 2010. According to Malaysia National Surveillance Antimicrobial Resistance (NSAR) which involves 41 participating hospitals, prevalence of CRKP has increased in the recent years, from 0.3% in 2011 to 2.8% in 2015. The Surveillance reported a rapid increase in the number of cases from 28 cases in 2011 to more than 800 cases in 2016. Polymixin resistance CRE cases were reported and it contributed to 21.7% Polymixin resistant enterobacteriaceae attributable death in year 2016 [1]
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