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

Autor: Hegazy EE; Department of Medical Microbiology and Immunology, Faculty of Medicine, Tanta University, Tanta, Egypt., Bahey MG; Department of Medical Microbiology and Immunology, Faculty of Medicine, Tanta University, Tanta, Egypt., Abo Hagar AM; Department of Anesthesiology, Surgical Intensive Care and Pain Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt., Elkholy AA; Department of Chest Diseases, Faculty of Medicine, Tanta University, Tanta, Egypt., Mohamed EA; Department of Medical Microbiology and Immunology, Faculty of Medicine, Tanta University, Tanta, Egypt.
Jazyk: angličtina
Zdroj: Infection and drug resistance [Infect Drug Resist] 2022 Oct 31; Vol. 15, pp. 6331-6342. Date of Electronic Publication: 2022 Oct 31 (Print Publication: 2022).
DOI: 10.2147/IDR.S385294
Abstrakt: Background: Ventilator-associated pneumonia (VAP) caused by carbapenem-resistant gram-negative bacteria has been proven to be an escalating public health challenge in Egypt owing to its high mortality rate and raised health care costs.
Purpose: Detection of carbapenem-resistant gram-negative bacilli among VAP patients, genotypic identification of carbapenemase genes in the isolated strains with evaluation of their impact on patient outcome and detection of carbapenemase-producing enterobacterales by MASTDISCS combi Carba plus disc system.
Methods: Broncho-alveolar lavage fluid (BALF) and endotracheal aspirate were collected aseptically from clinically suspected VAP patients. Pathogen identification and antibiotic sensitivity testing were done. Carbapenemase-encoding genes ( bla KPC , bla NDM , and bla OXA-48 ) were tested by PCR in all carbapenem-resistant gram-negative isolates. Performance of MASTDISCS combi Carba plus in isolated Enterobacterales was assessed in relation to the PCR results.
Results: Eighty-three carbapenem-resistant gram-negative isolates were detected. The most frequent pathogens were Klebsiella pneumoniae, Acinetobacter baumannii and Pseudomonas aeruginosa representing 34.9%, 20.5% and 18.1%, respectively. bla KPC was the predominant gene. Patients with persistent mechanical ventilation less than 15 days and Pseudomonas aeruginosa infection were significantly associated with a higher death rate. MAST-Carba plus had the highest sensitivity, specificity, positive and negative predictive values for detecting OXA-48 carbapenemases representing 81.8%, 92.5%, 75% and 94.9%, respectively.
Conclusion: Worse outcome in VAP patients was associated with carbapenem-resistant gram-negative bacilli. MASTDISCS combi Carba plus is an efficient simple method for identification of different carbapenemases among enterobacterales.
Competing Interests: The authors report no conflicts of interest in this work.
(© 2022 Hegazy et al.)
Databáze: MEDLINE
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