Basma A. El Awady1*, Mera G. Anan1, Hamida A. Goharand Mohamed H. Saleh2

1Department of Medical Microbiology and Immunology, Faculty of Medicine, Cairo University, Cairo, Egypt.
2Department of Critical Care, Faculty of Medicine, Cairo University, Cairo, Egypt.

DOI: http://dx.doi.org/10.22207/JPAM.11.4.03

(Received: 02 October 2017; accepted: 29 November 2017)

Abstract:

Carbapenems are a class of beta-lactam antibiotics with broad spectrum of activity. They are often considered as a last resort in treatment of infections caused by multidrug resistant organisms. Carbapenemase-producing Enterobacteriaceae (CPE) have been reported worldwide. Class D OXA-48 carbapenemases is rapidly disseminating in Enterobacteriaceae leading to high mortality from resistant and invasive CPE infections. In the present study, we attempted to isolate OXA-48 carbapenemase-producing Enterobacteriaceae from different clinical specimens obtained from hospitalized patients at different ICU of kasr Kasr Al-Ainy hospital, Cairo University. Initial screening for carbapenemase-producing Enterobacteriaceae was done using ertapenem disc diffusion method and direct inoculation of the specimens into ChromID OXA-48. The phenotypic Modified Hodge Test (MHT) was used for confirmation of carbapenemse production among screened carbapenem resistant isolates.Out of 112 collected samples, 94 Enterobacteriaceae were isolated. Fifty five isolates (58.5%) were ertapenem disc resistant and 50 isolates (53%) showed positive growth on ChromID OXA-48. Fifty two (94.5%) out of 55 suspected carbapenemase-producing isolates by disc diffusion method and the 50 isolates (100%) grown on ChromID OXA-48 were MHT positive. Our study underlines the need to detect OXA-48 CPE as early as possible to minimize its spread in ICU and apply appropriate infection control measures.

Keywords:

Enterobacteriaceae, class D OXA-48 carbapenemase, ChromID OXA-48, Modified Hodge Test.