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Carbapenem- and colistin-resistant Enterobacterales in intensive care unit patients in Mediterranean countries, 2019.
Dos Santos, Sandra; Diene, Seydina M; Benouda, Amina; Zerouali, Khalid; Ghaith, Doaa M; El-Mahdy, Rasha H; El Tayeb, Sawsan H M; Boutiba, Ilhem; Hammami, Adnene; Chrabieh, Remie; Daoud, Ziad; Mereghetti, Laurent; Francois, Patrice; Van Der Mee-Marquet, Nathalie.
Afiliación
  • Dos Santos S; Centre d'Appui pour la Prévention des Infections Associées aux Soins Centre Val de Loire, Centre Hospitalier Universitaire, Tours, France.
  • Diene SM; Faculté de Pharmacie, Aix-Marseille Université, Marseille, France.
  • Benouda A; Microbes Evolution Phylogeny and Infections (MEPHI), Aix-Marseille Université, Marseille, France.
  • Zerouali K; IHU-Méditerranée Infection, Aix-Marseille Université, Marseille, France.
  • Ghaith DM; Laboratoire de Microbiologie, Hôpital Cheikh Zaid, Rabat, Morocco.
  • El-Mahdy RH; Laboratoire de Microbiologie, Centre Hospitalier Universitaire Ibn Rochd, Faculté de Médecine et de Pharmacie, Casablanca, Morocco.
  • El Tayeb SHM; Clinical and Chemical Pathology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
  • Boutiba I; Department of Medical Microbiology and Immunology, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
  • Hammami A; Department of Medical Microbiology, Al Hussein University hospitals, Cairo, Egypt.
  • Chrabieh R; Laboratoire de Microbiologie, Centre Hospitalier Universitaire Charles Nicolle, Tunis, Tunisia.
  • Daoud Z; Laboratoire de Microbiologie, Centre Hospitalier Universitaire Habib Bourguiba, Sfax, Tunisia.
  • Mereghetti L; Department of Dermatology, Lebanese American University Medical Center Rizk Hospital, Beirut, Lebanon.
  • Francois P; Department of Biomedical Sciences, Faculty of Medicine and Medical Sciences, Saint George Hospital-UMC, Beirut, Lebanon.
  • Van Der Mee-Marquet N; Service de Bactériologie-Virologie-Hygiène, Centre Hospitalier Universitaire, Tours, France.
Front Microbiol ; 15: 1370553, 2024.
Article en En | MEDLINE | ID: mdl-38680922
ABSTRACT

Introduction:

The colonization of patients by carbapenemase-producing Enterobacterales (CPE) has been associated with heightened mortality, especially in vulnerable individuals within intensive care units (ICUs). Our study aimed to comprehensively assess CPE prevalence among ICU patients across the Mediterranean region pre-COVID-19, conducting a multicenter prevalence study in the first quarter of 2019.

Methods:

We collected clinical data and rectal or fecal samples from 256 ICU patients for CPE testing. Additionally, we performed whole-genome sequencing on 40 representative CPE strains to document their molecular characteristics.

Results:

Among the 256 patients, CPE was detected in 73 samples (28.5%), with prevalence varying from 3.3 to 69.0% across participating centers. We observed 13 colistin-resistant CPE strains, affecting three ICUs. Genetic analysis revealed highly diverse E. coli and K. pneumoniae strains, predominantly from international high-risk clones. Notably, blaOXA-48 and blaNDM-1 were the most prevalent carbapenemase genes. Molecular typing uncovered potential patient clusters in six centers. Significantly, longer hospital stays were associated with increased CPE carriage (p < 0.001). Nine centers across Morocco, Tunisia, Egypt, and Lebanon voluntarily participated.

Discussion:

Our study provides CPE prevalence in Mediterranean ICUs and reaffirms established CPE presence in this setting but also provides updates on the molecular diversity of CPE strains. These findings highlight the imperative of reinforcing infection control measures in the participating ICUs to curtail escalated mortality rates, and of strictly applying isolation measures around patients originating from the Mediterranean region when transferred to other healthcare institutions.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Front Microbiol Año: 2024 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Suiza
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Front Microbiol Año: 2024 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Suiza