ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2023
Genomic Insights Into the Mechanism of Carbapenem Resistance Dissemination in Enterobacterales From a Tertiary Public Heath Setting in South Asia.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.
- Prevalence and molecular epidemiology of carbapenem resistance in Asia: a systematic review and meta-analysis.Systematic reviews · 2025Pooled it
- Surveillance of enteropathogenicJournal of medical microbiology · 2026Article
- Novel Insights on Clinical Outcomes Using Integrated Shotgun Metagenomic Profiling of the Gut Microbiome, Resistome, and Host Immune-Inflammatory Response in Hospitalized Patients with Decompensated Cirrhosis.Pathogens (Basel, Switzerland) · 2026Article
- Clinical Characteristics, Antimicrobial Resistance Profiles and Carbapenemases Genotypes ofInfection and drug resistance · 2026Article
- Genomic and functional characterization of ST11-KL64 hypervirulence-associated carbapenem-resistantFrontiers in microbiology · 2026Article
- High-risk clonal expansion of IMP-producingAntimicrobial agents and chemotherapy · 2025Article
- Mobile genetic elements in shapingFrontiers in microbiology · 2025Review
- Distribution, epidemiology, and antimicrobial resistance pattern of gram-negative bacteria isolated from blood: A retrospective study in a tertiary care hospital, Dhaka, Bangladesh.PLOS global public health · 2025Article
- Comprehensive pathogen identification and antimicrobial resistance prediction from positive blood cultures using nanopore sequencing technology.Genome medicine · 2024Article
- Genomic characterization of carbapenemase-producing Enterobacterales from Dhaka food markets unveils the spread of high-risk antimicrobial-resistant clones and plasmids co-carryingJAC-antimicrobial resistance · 2024Article
- Whole-genome sequencing ofMicrobiology resource announcements · 2024Article
- Emergence of an IncX3 plasmid co-harbouring the carbapenemase genesJAC-antimicrobial resistance · 2024Article
- Article
- A Review of Carbapenem Resistance inMicroorganisms · 2023Review
- Insight into the Mechanisms of Carbapenem Resistance inAntibiotics (Basel, Switzerland) · 2023Article
- Carbapenem resistance inAIMS microbiology · 2023Review
- Genomic Characterization of an Extensively Drug-Resistant Extra-Intestinal Pathogenic (ExPEC)Antibiotics (Basel, Switzerland) · 2022Article
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Authors and funding
16 authors at 6 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
summary10.6% patients were CRE positive. Only 27% patients were prescribed at least 1 antibiotic to which infecting pathogen was susceptible. Burn and ICU admission and antibiotics exposures facilitate CRE acquisition. Escherichia coli ST167 was the dominant CRE clone.
backgroundGiven the high prevalence of multidrug resistance (MDR) across South Asian (SA) hospitals, we documented the epidemiology of carbapenem-resistant Enterobacterales (CRE) infections at Dhaka Medical College Hospital between October 2016 and September 2017.
methodsWe enrolled patients and collected epidemiology and outcome data. All Enterobacterales were characterized phenotypically and by whole-genome sequencing. Risk assessment for the patients with CRE was performed compared with patients with carbapenem-susceptible Enterobacterales (CSE).
results10.6% of all 1831 patients with a clinical specimen collected had CRE. In-hospital 30-day mortality was significantly higher with CRE [50/180 (27.8%)] than CSE [42/312 (13.5%)] (P = .001); however, for bloodstream infections, this was nonsignificant. Of 643 Enterobacterales isolated, 210 were CRE; blaNDM was present in 180 isolates, blaOXA-232 in 26, blaOXA-181 in 24, and blaKPC-2 in 5. Despite this, ceftriaxone was the most commonly prescribed empirical antibiotic and only 27% of patients were prescribed at least 1 antibiotic to which their infecting pathogen was susceptible. Significant risk factors for CRE isolation included burns unit and intensive care unit admission, and prior exposure to levofloxacin, amikacin, clindamycin, and meropenem. Escherichia coli ST167 was the dominant CRE clone. Clustering suggested clonal transmission of Klebsiella pneumoniae ST15 and the MDR hypervirulent clone, ST23. The major trajectories involved in horizontal gene transfer were IncFII and IncX3, IS26, and Tn3.
conclusionsThis is the largest study from an SA public hospital combining outcome, microbiology, and genomics. The findings indicate the urgent implementation of targeted diagnostics, appropriate antibiotic use, and infection-control interventions in SA public institutions.
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