Carbapenem-Resistant Enterobacteriaceae among In-Patients of Tertiary Hospitals in Southwest, Nigeria

Abstract

The study assessed the incidence and risk factor associated with the occurrence of carbapenem-resistant Enterobacteriaceae (CRE) among hospitalized patients at three tertiary hospitals in Southwest, Nigeria. A cross-sectional study was performed over a six-month surveillance period in the locations with a total of 300 blood and urine samples. A structured close-ended questionnaire was also administered to all subjects for review of demographics and potential risk factors. Fifty-nine isolates belonging to genera Escherichia (52.5%), Enterobacter (23.8%), Klebsiella (10.2%) and Proteus (13.6%) were isolated. All the isolates were multi-drug resistant with a notable resistance (100%) to cephalosporins and significant sensitivity to nitrofurantoin. A total of 23 isolates including Escherichia coli (n = 8), Enterobacter aerogenes (n = 9), Klebsiella pneumoniae (n = 1) and Proteus mirabilis (n = 5) exhibited resistance to one or both of imipenem and meropenem. The overall incidence of CRE in the three locations at the time of study was 7.7%. Age (p = 0.01) and exposure to invasive devices were significant risk factors for CRE colonization. Although at low incidence, the occurrence of CRE among this group calls for active monitoring because of its implication fatality of infections as well as the propensity to spread.

Keywords

• carbapenem
• carbapenem-resistant
• enterobacteriaceae
• in-patients
• multi-drug resistance