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Prevalence of carbapenem-resistant enterobacteriaceae in a tertiary care referral Centre: Kerala, South India

Author: 
Rohey Jan, Nita George, Mohan Mathew, Waseem Raja, Molly Johny, Vipin Lal and George. P.
Subject Area: 
Health Sciences
Abstract: 

Objective: The emergence of Carbapenem Resistant Enterobacteriaceae (CRE) in recent times has become a serious threat to public health due to the high mortality, potential dissemination rates and limited availability of effective treatment options. Aims/objective: The aim of the study was to determine the prevalence rate of CRE in ICU settings at Lakeshore hospital & research centre Kochi –Kerala. Methods: A Retrospective study was conducted in Critical care department over a period of 1 year from January 2015 – December 2015, following its approval by the institutional ethical committee. A total of 1035 susceptible isolates were retrieved from the electronic medical records (EMR) of the hospital. The study sample includes patients from all ICU, s and specimens tested for culture sensitivity were blood, urine, endotrachial aspirate, sputum, wound pus/abscess and others. Results : The total number of Enterobacteriace isolates were 624 (60.3%), out of which CRE isolates were 50, with CRE Prevelance rate of 8.0 %, (50/624). The most common organisms identified were Klebsella pneumoniae 82% followed by E. Coli 18% & the most common sources of CRE isolates were ET aspirates (22%), followed by urine culture (18%). Majority of the CRE isolates were found in age group of 61-75 years (42%), followed by 46-60 yrs (24%) with male prepondance (2.1:1). CRE isolates were mainly sensitive to Tigecycline (70%), Colistin (50%) and amikacin (40%). Conclusion: This study provides a baseline data of current scenario of CRE in our set up. A strict antibiotic policy should be addressed especially with observed emergence of carbapenem resistance. Continuous review of need to invasive devices and strict compliance with basic infection control measures are mandatory to limit the spread of CRE.

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