Characteristics of Carbapenem-Resistant Gram-Negative Bacilli in Patients with Ventilator-Associated Pneumonia

Abstract

Carbapenem-resistant Gram-negative bacilli (CR-GNB) has become a global threat. In hospital settings, the association of CR-GNB with ventilator-associated pneumonia (VAP) is a critical public health concern owing to their high resistance rate to most antibiotics. The present study aims to identify the frequency of carbapenem-resistance and to determine the rate of multidrug resistance (MDR), extensive drug resistance (XDR) and pan-drug resistance (PDR) among CR-GNB infections in VAP. Antimicrobial susceptibility testing was carried out using the disk diffusion method and the detection of carbapenemases was screened using the imipenem-E test and the modified carbapenem-inactivation method (mCIM). The isolates were verified by polymerase chain reaction (PCR) for the presence of blaNDM, blaSPM, blaVIM, blaIMP and blaGIM genes. 89.5%, 14%, 17.5%, 10.5%, 3.5% of isolates exhibited the presence of blaNDM, blaVIM, blaSPM, blaIMP and blaGIM, respectively. 76%, 17% and 7% of isolates were PDR, XDR, and MDR, respectively. Carbapenem-resistance genes were identified in a significant percentage and blaNDM was the most predominant gene. All isolates were highly resistant to most antibiotics. This health concern has proven to be a big challenge in developing countries such as Egypt, as it is associated with high morbidity, high mortality, and raised healthcare costs.

Carbapenem-Resistant Gram-Negative Bacilli Causing Ventilator Associated Pneumonia: Study of MASTDISCS Combi Carba Plus for Detection of Carbapenemase Producing Enterobacterales

“…33 Concerning the type of bacteria detected in the current study, K. pneumoniae was the predominant isolate, followed by A. baumannii, P. aeruginosa and E. coli, representing 34.9%, 20.5%, 18.1% and 12%, respectively. This result was in agreement with Mohammed et al and Gajdacs et al 34,35 In contrast, greater prevalence of P. aeruginosa was detected in other studies. 36,37 Meanwhile, Chen et al, Kumari et al, and Sadigov et al reported that A. baumannii was the most prevalent CR-GNB pathogen, accounting for 78.7%, 37.4%, and 37.1%, respectively.…”

Characterization of Carbapenem-Resistant K. Pneumoniae Isolated from Intensive Care Units of Zagazig University Hospitals

“…Multiplex PCR was used to detect the five significant carbapenemase-encoding genes in K. pneumoniae ( bla KPC , bla NDM , bla VIM, bla IMP , and bla OXA-48 ) [ 12 ]. A total volume of 30 µL was adequately prepared for the PCR reaction mixture, including 5 µL (100 ng) of template DNA, 15 µL of PCR master mix, and 2 µL (5 pmol) of each primer ( Table 9 ) [ 57 , 58 ]. The volume was then completed with nuclease-free water up to 30 µL.…”

Clinical characteristics and pathogen analysis of bronchoalveolar lavage fluid in elderly patients with community‐acquired pneumonia

“…Because they are highly resistant to most antibiotics. 33 In this study, more than half of the CAP patients had these bacteria in their etiological cultures. This means that the use of antibiotics in these groups is limited.…”