Detection of OXA-48-Carbapenemase-Producing Enterobacteriaceae using ChromID OXA-48 in Critical Care Patients in Egypt

Abstract

Carbapenems are a class of beta-lactam antibiotics with broad spectrum of activity. They are often considered as a last resort in treatment of infections caused by multidrug resistant organisms. Carbapenemase-producing Enterobacteriaceae (CPE) have been reported worldwide. Class D OXA-48 carbapenemases is rapidly disseminating in Enterobacteriaceae leading to high mortality from resistant and invasive CPE infections. In the present study, we attempted to isolate OXA-48 carbapenemase-producing Enterobacteriaceae from different clinical specimens obtained from hospitalized patients at different ICU of kasr Kasr Al-Ainy hospital, Cairo University. Initial screening for carbapenemase-producing Enterobacteriaceae was done using ertapenem disc diffusion method and direct inoculation of the specimens into ChromID OXA-48. The phenotypic Modified Hodge Test (MHT) was used for confirmation of carbapenemse production among screened carbapenem resistant isolates.Out of 112 collected samples, 94 Enterobacteriaceae were isolated. Fifty five isolates (58.5%) were ertapenem disc resistant and 50 isolates (53%) showed positive growth on ChromID OXA-48. Fifty two (94.5%) out of 55 suspected carbapenemase-producing isolates by disc diffusion method and the 50 isolates (100%) grown on ChromID OXA-48 were MHT positive. Our study underlines the need to detect OXA-48 CPE as early as possible to minimize its spread in ICU and apply appropriate infection control measures.

Keywords

• enterobacteriaceae
• class d oxa-48 carbapenemase
• chromid oxa-48
• modified hodge test