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Fereshteh Shahcheraghi

Fereshteh Shahcheraghi

Pasteur Institute
Iran

Title: Fecal carriage of carbapenem resistance Enterobacteriaceae among inpatients in a university hospital in Iran

Biography

Biography: Fereshteh Shahcheraghi

Abstract

Objectives: Fecal colonization by carbapenem-resistant Enterobacteriaceae (CRE) could serve as a reservoir for transmission of these pathogens to clinical settings, which subsequently increases clinical infections. The aim of this study was to evaluate the prevalence and risk factors associated with CRE fecal colonization among inpatients.

Material and Methods: Rectal swabs from 50 patients in a university hospital were collected. CRE screening was performed by using selective media. Carbapenemase production was detected by phenotypic tests. PCR assays were used to detect carbapenemases genes. Clonal relatedness was investigated by pulsed-field gel electrophoresis (PFGE).

Results: The prevalence of fecal colonization was 56% (28/50). Overall, 41 CRE isolates were identified, of which 38 were carbapenemase-producers. Eleven patients (39.3%) were co-colonized with CRE isolates. ICU hospitalization, prior antibiotic therapy, and mechanical ventilation were significant risk factors. The blaOXA-48 was the most frequent carbapenemases followed by blaNDM-1 andblaNDM-7 enzyme. Nine carpapenemase producing Enterobacteriaceae (CPE) isolates co-harbored blaNDM-1 and blaOXA-48. Also, six CPE isolates co-harboredblaNDM-7 and blaOXA-48.We did not detect blaKPC, blaGES, blaIMP and blaVIM. PFGE analysis showed that E. coli clones were diverse, while K. pneumoniae categorize in 3 clusters. Cluster I was the major clone carrying blaOXA-48and blaCTXM-15 genes.

Conclusions: Our study as the first investigation in Iran showed CRE not only had high prevalence in fecal carriages, but also harbored varied antimicrobial resistance elements. 

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