Prevalence of enterobacteria producing carbapenemases and BLSE in the adult resuscitation environment at Hassan ii hospital in Fes

Abstract

Enterobacteriaceae producing carbapenemases (EPCs) and extended-spectrum betalactamases (E-BLSEs) are an emerging threat. The aim of this study is to specify the epidemiological profile of E-BLSEs and EPCs, determine their prevalence in patients hospitalized in the adult intensive care unit of the CHU Hassan II hospital center, and describe their current antibiotic resistance profile for better patient management based on local data. Our study is retrospective, carried out at the microbiology laboratory of CHU HASSAN II in Fez over a one-year period from January 1, 2022 to December 31, 2022, and concerns all E-BLSE and EPC strains isolated from all urine, pus, blood cultures and respiratory samples taken from adult intensive care units at CHU Hassan II in Fez. Of the 1,792 bacteriological samples processed during this period, 352 were positive for Gram-negative bacilli (GNB), including 71 BMR, giving an overall prevalence of 20.17%. During our study, we retained 71 BMR, including carbapenemase-producing enterobacteria with 30.98% of cases (22 strains) and 49 strains of E-BLSE B (64.01%). The overall prevalence of EPCs among enterobacteria was 6.25%. The blaOX-48 gene predominated at (45.45%), followed by bla-NDM a (31.81%).and finally the two genes with a (22.72%). The overall prevalence of E-BLSE was 14%. Among these E-BLSE, Escherichia coli constituted the majority (59.18%) of isolates, followed by Klebsiella pneumoniae with a rate of (32.65%). Then Enterobacter cloacae with a rate of (8.16%). All EPC enterobacteria isolated showed resistance to quinolones. However, the sensitivity of our strains to amikacin was 98%, while colistin showed a sensitivity rate of 100%. This study has shown that the prevalence of EBLSE and EPC in the adult intensive care setting is significant. We need to continue our efforts in early detection of these BMRs in hospitals to control their spread both in the hospital environment and in the community.