We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Emergence of nosocomial-acquired extensively drug-resistant and pandrug-resistant Enterobacterales in a teaching hospital in Kuwait.
- Authors
Chadha, A.; Jamal, W.; Rotimi, V. O.
- Abstract
Background: The emergence and high ascendancy of infections caused by extensively-drug-resistant (XDR) and pandrug-resistant (PDR) Enterobacterales isolates is a serious clinical and public health challenge. Isolation of PDR Gram-negative bacteria (GNB) in clinical setting is very rare and rarer is the infection caused by XDR GNB. Apart from restricted therapeutic options, these infections are associated with increased mortality and morbidity. Urgent studies to re-evaluate existing therapeutic options and research into new antibiotic molecules are desperately needed. The objectives of this study are to report the emergence of rarely encountered multidrug-resistant (MDR), difficult-to-threat, CRE infections in our hospital and investigate their molecular epidemiology. Methodology: This was a retrospective observational analysis of six patients with severe infections caused by XDR and PDR Enterobacterales isolates at Mubarak AL Kabeer Teaching Hospital, Jabriya, Kuwait, over a period of one and half years. The mechanisms of resistance in these isolates were then prospectively investigated by molecular characterization and genomic studies. Results: The majority of infections were caused by Klebsiella pneumoniae (83.3%, 5/6) and one (16.6%) was caused by Escherichia coli. Three patients had bloodstream infection (BSI), one had both BSI and urinary tract infection (UTI), one had respiratory tract infection, and the last one had UTI. Two patients were infected with OXA-48 producers, one patient was infected with NDM-1 producer, one patient was infected with NDM-5 producer, one patient was infected with both NDM-1 and OXA-48 producer and the last patient was infected with both NDM-5 and OXA-181 producer. For definite treatment, all patients received combination therapy. The mortality rate was high (50.0%). Conclusion: The high mortality rate associated with XDR and PDR Enterobacterales infections and the limited antimicrobial options for treatment highlight the need for improved detection of these infections, identification of effective preventive measures, and development of novel agents with reliable clinical efficacy against them.
- Subjects
KUWAIT; TEACHING hospitals; URINARY tract infections; RESPIRATORY infections; KLEBSIELLA pneumoniae; MOLECULAR epidemiology; NOSOCOMIAL infections; DRUG resistance
- Publication
African Journal of Clinical & Experimental Microbiology, 2022, Vol 23, Issue 4, p426
- ISSN
1595-689X
- Publication type
Article
- DOI
10.4314/ajcem.v23i4.11