ArticleThe Indian journal of medical research2025
Molecular characterization & risk factors associated with carbapenemase-producing enterobacterales acquisition in hospitalised patients in a tertiary care setting.
Article in The Indian journal of medical research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Abstract
Background & objectives Carbapenem-resistant Enterobacterales (CREs) have emerged as a major global public health threat, leading to increasing morbidity, mortality, and healthcare costs. This study aimed to characterise the molecular profile of CRE isolates and identify clinical and epidemiological risk factors associated with the acquisition of carbapenemase-producing Enterobacterales (CPE). Methods This cross-sectional study was conducted from October 2023 to July 2024. Clinical isolates from hospitalized patients were identified and speciated using standard microbiological procedures and confirmed by the VITEK-2 compact. Confirmed CRE isolates were subjected to multiplex PCR for carbapenemase gene detection. Statistical analysis included bivariate and multivariate logistic regression to determine independent predictors of CPE acquisition. Results Among 104 Enterobacterales isolates, 58 (55.8%) wereCarbapenemase producing (CP)-CRE, and 46 (44.2%) were non-CP-CRE. K. pneumoniae (40/58, 69.0%) and E. coli (13/58, 22.4%) were the predominant CPE species. Molecular analysis revealed that 34 (58.6%) of CPE isolates harboured only blaNDM, 4 (6.9%) carried blaOXA-48, and 20 (34.5%) exhibited coproduction of multiple carbapenemases. Significant risk factors for CPE acquisition included prolonged hospital stay [≥5 days; odds ratio (OR)=103.81, P=0.009], presence of surgical site infections (OR=76.78, P=0.047), prior carbapenem use (OR=48.61, P=0.001), and invasive procedures or indwelling devices (OR=34.37, P=0.014). CP-CRE isolates exhibited high resistance (70-90%) to fluoroquinolones, aztreonam, aminoglycosides, and tetracyclines, moderate resistance to tigecycline, and the lowest to colistin (2/58, 3.5%). Interpretation & conclusions This study revealed a high prevalence of CP-CRE, predominantly blaNDM-producing K. pneumoniae. CP-CRE infections were associated with multidrug resistance, increased mortality, and risk factors like prolonged hospitalisation, surgical procedures, and previous carbapenem exposure.
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