Prevalence of faecal carriage of Enterobacteriaceae with NDM-1 carbapenemase at military hospitals in Pakistan, and evaluation of two chromogenic media

Perry, John D., Naqvi, Sakeenah Hussain, Mirza, Irfan Ali, Alizai, Shehla Ambreen, Hussain, Aamir, Ghirardi, Sandrine, Orenga, Sylvain, Wilkinson, Kathryn, Woodford, Neil, Zhang, Jiancheng, Livermore, David M. ORCID: https://orcid.org/0000-0002-9856-3703, Abbasi, Shahid Ahmad and Raza, Muhammad W. (2011) Prevalence of faecal carriage of Enterobacteriaceae with NDM-1 carbapenemase at military hospitals in Pakistan, and evaluation of two chromogenic media. Journal of Antimicrobial Chemotherapy, 66 (10). pp. 2288-2294. ISSN 0305-7453

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Abstract

Objectives: To determine the prevalence and antimicrobial susceptibility of carbapenemase-producing Enterobacteriaceae among hospitalized patients and outpatients attending two military hospitals in Rawalpindi, Pakistan, and to compare the performance of two chromogenic culture media for the isolation of these organisms. Methods: Stool samples from 200 distinct patients were cultured on MacConkey agar and subsequently on two chromogenic media—Colorex KPC and a prototype chromogenic medium, ID Carba—designed for the isolation of carbapenemase-producing Enterobacteriaceae. All Gram-negative isolates growing on either chromogenic medium were investigated for carbapenemases by phenotypic and molecular methods. Producers were subjected to susceptibility testing with 40 antimicrobials by VITEK 2 or agar dilution. Results: In total, 64 NDM-1-positive isolates of Enterobacteriaceae, belonging to seven distinct species, were recovered from 37 (18.5%) of the stool samples. No other carbapenemase types were confirmed. Nineteen positive samples were identified among 70 from inpatients (prevalence 27.1%) and there were 18 positive samples among 130 from outpatients (prevalence 13.8%). Fifty-six isolates (87.5%) harbouring the NDM-1 enzyme were recovered on ID Carba compared with 41 isolates (64.1%) on Colorex KPC (P = 0.012). Multidrug resistance was prevalent, but no pan-resistant isolates were found, with most isolates susceptible in vitro to colistin (97%), mecillinam (95%), fosfomycin (94%), tigecycline (89%) and nitrofurantoin (78%). Conclusions: This study shows a high prevalence of multidrug-resistant Enterobacteriaceae with the NDM-1 enzyme in Rawalpindi. The new chromogenic medium, ID Carba, was more sensitive than Colorex KPC and has potential as a screening medium for isolation of Enterobacteriaceae harbouring the NDM-1 enzyme.

Item Type: Article
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups: Faculty of Medicine and Health Sciences > Research Groups > Public Health and Health Services Research (former - to 2023)
Faculty of Medicine and Health Sciences > Research Groups > Epidemiology and Public Health
Depositing User: Sophie Buckingham
Date Deposited: 05 Mar 2013 10:59
Last Modified: 16 Jan 2024 01:20
URI: https://ueaeprints.uea.ac.uk/id/eprint/41703
DOI: 10.1093/jac/dkr299

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