PP10 - Trend analysis of prevalence of Carbapenem-Resistant Enterobacterales and Vancomycin-Resistant Enterococci in blood culture isolates in a tertiary care hospital in Sri Lanka
Abstract
Introduction
Due to their increasing prevalence, carbapenem resistance Enterobacterales (CRE) and Vancomycin-resistant enterococcus (VRE) are considered major public health concerns. Infections due to these resistant organisms are mostly healthcare-associated and, therefore, are preventable. The main drive for developing these infections is the overuse and misuse of broad-spectrum antibiotics. Infections due to CRE and VRE cause high morbidity and mortality due to a lack of accessibility to newer, effective antimicrobials. Understanding the changing epidemiology of these important pathogens is essential in formulating preventive strategies and policymaking.
Objectives
To determine the trends of CRE and VRE in blood culture isolates in Colombo North Teaching Hospital Ragama (CNTH).
Design, setting, and methods
This descriptive cross-sectional study analyzed clinically significant blood cultures positive for Enterobacterales and enterococci from 2019 to 2024 to determine CRE and VRE rates using the WHOnet software. Organism identification and susceptibility testing were performed with gram stain and relevant biochemical tests, and susceptibility was performed according to CLSI standards. When available, identification up to species level and MIC determination were made using the BD PhoenixTM automated identification and susceptibility testing system.
Results
The total number of enterobacterales considered for this study from 2019 to 2024 were 204,186,191,49,181 and 87, respectively. The corresponding CRE rates were 23.2%,20.3%,18.1%, 36.4%,37% and 32.9%. The number of Enterococcus faecalis and Enterococcus feacium isolates and the VRE rates from 2019 were as follows: 6(50%),11(54%),21(24%),11(18%),4(25%), and 14(14%). Most of the CRE isolates were Klebsiella pneumoniae. A total of 15 VRE isolates were identified, and 80% were Enterococcus feacium.
Conclusion
This study reveals increasing trends in CRE and VRE, followed by a decreasing trend in 2024. The main limitation was the small sample size due to the inability to identify all Streptococcus/Enterococcus isolates up to the species level. Continuous surveillance of CRE and VRE helps monitor the effectiveness of antimicrobial resistance containment strategies, including antibiotic stewardship programs in healthcare facilities and the community.
Downloads
