Carbapenemase-Producing Enterobacteriaceae (CPE) pose an increasing global health concern, particularly due to their rapid spread and potential to cause severe infections. Quick and efficient patient screening, coupled with stringent infection control measures, can help prevent CPE colonization from escalating into grave infections. A research study conducted at a tertiary hospital in Istanbul, Turkiye strived to investigate this matter further, focusing on the incidence of carbapenem-resistant Enterobacteriaceae (CRE) colonization and the prevalence of various CRE species and carbapenemase gene types in patients undergoing CRE screening tests. The screening test samples were obtained from rectal swabs and analyzed using both the CHROMAgar culture method and real-time Polymerase Chain Reaction (PCR) technique.
The study additionally assessed the effectiveness of PCR and CHROMAgar methods in diagnosing whether patients with CRE colonization developed meropenem-resistant infection sites during their hospital stay. The process encompassed a retrospective study carried out in the Microbiology Laboratory involving 3953 patients at Başakşehir Çam and Sakura City Hospital in Istanbul from January 2021 to December 2023.
The findings revealed the prevalence of CRE colonization using both PCR and CHROMAgar. Among the enterobacterial species, Klebsiella pneumoniae and Escherichia coli were the most frequently occurring bacteria. The PCR results showed the presence of OXA-48, blaNDM, blaKPC, and bla VIM/IMP genes, with single genes being most common. Importantly, infection developed in a subset of patients colonized with CRE during their hospital stay. However, the rate of infection was lower in patients identified via PCR compared to those identified via chromogenic agar. Hence, this underlines the utility of PCR for early detection of CRE colonization, leading to immediate isolation and intervention steps.
Despite the higher detection rate of CRE colonization with PCR, the progression to infection was lower with the CHROMAgar method. The study findings underscore the high rate of CRE colonization, necessitating vigilant monitoring through infection control procedures. Prominently, the co-production of three CRE genes in some patients delineates concerns regarding the continuous emergence of multi-resistant Enterobacteriaceae.
Source: https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-025-11111-1