Carbapenem-Resistant Gram-Negative Bacilli Causing Ventilator Associated Pneumonia: Study of MASTDISCS Combi Carba Plus for Detection of Carbapenemase Producing Enterobacterales
Eman E Hegazy,1 Marwa Gamal Bahey,1 Alaa Mohammed Abo Hagar,2 Amira Abdelgalil Elkholy,3 Esraa A Mohamed1 1Department of Medical Microbiology and Immunology, Faculty of Medicine, Tanta University, Tanta, Egypt; 2Department of Anesthesiology, Surgical Intensive Care and Pain Medicine, Faculty of Medi...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2022-10-01
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| Series: | Infection and Drug Resistance |
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| Online Access: | https://www.dovepress.com/carbapenem-resistant-gram-negative-bacilli-causing-ventilator-associat-peer-reviewed-fulltext-article-IDR |
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| author | Hegazy EE Bahey MG Abo Hagar AM Elkholy AA Mohamed EA |
| author_facet | Hegazy EE Bahey MG Abo Hagar AM Elkholy AA Mohamed EA |
| author_sort | Hegazy EE |
| collection | DOAJ |
| description | Eman E Hegazy,1 Marwa Gamal Bahey,1 Alaa Mohammed Abo Hagar,2 Amira Abdelgalil Elkholy,3 Esraa A Mohamed1 1Department of Medical Microbiology and Immunology, Faculty of Medicine, Tanta University, Tanta, Egypt; 2Department of Anesthesiology, Surgical Intensive Care and Pain Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt; 3Department of Chest Diseases, Faculty of Medicine, Tanta University, Tanta, EgyptCorrespondence: Eman E Hegazy, Tel +20 10 99008274, Email dr_emanhegazy2010@yahoo.comBackground: Ventilator-associated pneumonia (VAP) caused by carbapenem-resistant gram-negative bacteria has been proven to be an escalating public health challenge in Egypt owing to its high mortality rate and raised health care costs.Purpose: Detection of carbapenem-resistant gram-negative bacilli among VAP patients, genotypic identification of carbapenemase genes in the isolated strains with evaluation of their impact on patient outcome and detection of carbapenemase-producing enterobacterales by MASTDISCS combi Carba plus disc system.Methods: Broncho-alveolar lavage fluid (BALF) and endotracheal aspirate were collected aseptically from clinically suspected VAP patients. Pathogen identification and antibiotic sensitivity testing were done. Carbapenemase-encoding genes (blaKPC, blaNDM, and blaOXA-48) were tested by PCR in all carbapenem-resistant gram-negative isolates. Performance of MASTDISCS combi Carba plus in isolated Enterobacterales was assessed in relation to the PCR results.Results: Eighty-three carbapenem-resistant gram-negative isolates were detected. The most frequent pathogens were Klebsiella pneumoniae, Acinetobacter baumannii and Pseudomonas aeruginosa representing 34.9%, 20.5% and 18.1%, respectively. blaKPC was the predominant gene. Patients with persistent mechanical ventilation less than 15 days and Pseudomonas aeruginosa infection were significantly associated with a higher death rate. MAST-Carba plus had the highest sensitivity, specificity, positive and negative predictive values for detecting OXA-48 carbapenemases representing 81.8%, 92.5%, 75% and 94.9%, respectively.Conclusion: Worse outcome in VAP patients was associated with carbapenem-resistant gram-negative bacilli. MASTDISCS combi Carba plus is an efficient simple method for identification of different carbapenemases among enterobacterales.Keywords: Mast DISCS, carbapenemase, enterobacterales, ventilator-associated pneumonia, VAP |
| first_indexed | 2024-04-11T08:17:22Z |
| format | Article |
| id | doaj.art-db11f18847a443418e5432298616d9b2 |
| institution | Directory Open Access Journal |
| issn | 1178-6973 |
| language | English |
| last_indexed | 2024-04-11T08:17:22Z |
| publishDate | 2022-10-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Infection and Drug Resistance |
| spelling | doaj.art-db11f18847a443418e5432298616d9b22022-12-22T04:35:05ZengDove Medical PressInfection and Drug Resistance1178-69732022-10-01Volume 156331634279344Carbapenem-Resistant Gram-Negative Bacilli Causing Ventilator Associated Pneumonia: Study of MASTDISCS Combi Carba Plus for Detection of Carbapenemase Producing EnterobacteralesHegazy EEBahey MGAbo Hagar AMElkholy AAMohamed EAEman E Hegazy,1 Marwa Gamal Bahey,1 Alaa Mohammed Abo Hagar,2 Amira Abdelgalil Elkholy,3 Esraa A Mohamed1 1Department of Medical Microbiology and Immunology, Faculty of Medicine, Tanta University, Tanta, Egypt; 2Department of Anesthesiology, Surgical Intensive Care and Pain Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt; 3Department of Chest Diseases, Faculty of Medicine, Tanta University, Tanta, EgyptCorrespondence: Eman E Hegazy, Tel +20 10 99008274, Email dr_emanhegazy2010@yahoo.comBackground: Ventilator-associated pneumonia (VAP) caused by carbapenem-resistant gram-negative bacteria has been proven to be an escalating public health challenge in Egypt owing to its high mortality rate and raised health care costs.Purpose: Detection of carbapenem-resistant gram-negative bacilli among VAP patients, genotypic identification of carbapenemase genes in the isolated strains with evaluation of their impact on patient outcome and detection of carbapenemase-producing enterobacterales by MASTDISCS combi Carba plus disc system.Methods: Broncho-alveolar lavage fluid (BALF) and endotracheal aspirate were collected aseptically from clinically suspected VAP patients. Pathogen identification and antibiotic sensitivity testing were done. Carbapenemase-encoding genes (blaKPC, blaNDM, and blaOXA-48) were tested by PCR in all carbapenem-resistant gram-negative isolates. Performance of MASTDISCS combi Carba plus in isolated Enterobacterales was assessed in relation to the PCR results.Results: Eighty-three carbapenem-resistant gram-negative isolates were detected. The most frequent pathogens were Klebsiella pneumoniae, Acinetobacter baumannii and Pseudomonas aeruginosa representing 34.9%, 20.5% and 18.1%, respectively. blaKPC was the predominant gene. Patients with persistent mechanical ventilation less than 15 days and Pseudomonas aeruginosa infection were significantly associated with a higher death rate. MAST-Carba plus had the highest sensitivity, specificity, positive and negative predictive values for detecting OXA-48 carbapenemases representing 81.8%, 92.5%, 75% and 94.9%, respectively.Conclusion: Worse outcome in VAP patients was associated with carbapenem-resistant gram-negative bacilli. MASTDISCS combi Carba plus is an efficient simple method for identification of different carbapenemases among enterobacterales.Keywords: Mast DISCS, carbapenemase, enterobacterales, ventilator-associated pneumonia, VAPhttps://www.dovepress.com/carbapenem-resistant-gram-negative-bacilli-causing-ventilator-associat-peer-reviewed-fulltext-article-IDRmast discscarbapenemaseenterobacteralesventilator-associated pneumoniavap |
| spellingShingle | Hegazy EE Bahey MG Abo Hagar AM Elkholy AA Mohamed EA Carbapenem-Resistant Gram-Negative Bacilli Causing Ventilator Associated Pneumonia: Study of MASTDISCS Combi Carba Plus for Detection of Carbapenemase Producing Enterobacterales Infection and Drug Resistance mast discs carbapenemase enterobacterales ventilator-associated pneumonia vap |
| title | Carbapenem-Resistant Gram-Negative Bacilli Causing Ventilator Associated Pneumonia: Study of MASTDISCS Combi Carba Plus for Detection of Carbapenemase Producing Enterobacterales |
| title_full | Carbapenem-Resistant Gram-Negative Bacilli Causing Ventilator Associated Pneumonia: Study of MASTDISCS Combi Carba Plus for Detection of Carbapenemase Producing Enterobacterales |
| title_fullStr | Carbapenem-Resistant Gram-Negative Bacilli Causing Ventilator Associated Pneumonia: Study of MASTDISCS Combi Carba Plus for Detection of Carbapenemase Producing Enterobacterales |
| title_full_unstemmed | Carbapenem-Resistant Gram-Negative Bacilli Causing Ventilator Associated Pneumonia: Study of MASTDISCS Combi Carba Plus for Detection of Carbapenemase Producing Enterobacterales |
| title_short | Carbapenem-Resistant Gram-Negative Bacilli Causing Ventilator Associated Pneumonia: Study of MASTDISCS Combi Carba Plus for Detection of Carbapenemase Producing Enterobacterales |
| title_sort | carbapenem resistant gram negative bacilli causing ventilator associated pneumonia study of mastdiscs combi carba plus for detection of carbapenemase producing enterobacterales |
| topic | mast discs carbapenemase enterobacterales ventilator-associated pneumonia vap |
| url | https://www.dovepress.com/carbapenem-resistant-gram-negative-bacilli-causing-ventilator-associat-peer-reviewed-fulltext-article-IDR |
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