Molecular Detection of Carbapenem Resistance Genes in Rectal Swabs from Patients in Gulf Cooperation Council Hospitals

Document Type

Article

Publication Date

3-26-2021

Publication Source

Journal of Hospital Infection

Abstract

Background: Gram-negative organisms harbouring carbapenem resistance genes (CRGs) are spreading globally, including in Gulf Cooperation Council (GCC) countries. However, relatively few data are available about carriage of CRGs in hospitalized patients in this region.

Aim: To determine prevalence of CRG carriage and risk factors for colonization among patients in GCC hospitals.

Methods: Rectal swabs were obtained from ∼50 intensive care unit (ICU) patients from each of 11 hospitals in five GCC countries between March and November 2019. The swabs were tested for the presence of blaKPC, blaNDM, blaVIM, blaIMP, and blaOXA-48 CRG using a commercial polymerase chain reaction test. Data on risk factors for colonization were collected and analysed.

Findings: Of 529 specimens screened, 138 (26.1%) were positive for one or more CRGs. The positivity rates among the hospitals ranged from 8.0% to 67.3%; ∼20% of the positive specimens harboured ≥2 CRGs. The most common CRG detected was blaOXA-48, which was present in 82 specimens (15.5%). Additional CRGs included blaNDM, blaVIM, blaKPC, and blaIMP either alone or in combination. Overall, 31.1% of patients on antibiotics on admission to the ICU were positive for CRGs compared to 16.5% not on antibiotic therapy (P < 0.001). CRG detection was also more common among patients aged >65 years (P = 0.027) and increased with hospital length of stay (P = 0.025).

Conclusion: The rate of CRGs detected in hospitalized patients in GCC countries varied considerably. Prior antibiotic exposure, increasing age, and prolonged length of stay were associated with CRG detection.

Inclusive pages

96-103

ISBN/ISSN

Online ISSN: 1532-2939; Print ISSN: 0195-6701

Document Version

Postprint

Comments

The accepted manuscript of this publication will made available in compliance with the publisher’s policy on self-archiving. Permission documentation is on file. Until then, use the link to the DOI.

Publisher

Elsevier

Volume

112

Peer Reviewed

yes

Keywords

Carbapenem resistance; Carbapenemase genes; Surveillance; Gulf Cooperation Council; OXA-48; CRE


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