Evaluating the frequency and antibiotic susceptibility pattern of Carbapenem resistant Enterobacteriaceae isolated from burn patients

Abstract

Carbapenems are a class of β-lactam antibiotics that are commonly used to treat multidrug-resistant (MDR) Gram-negative bacteria. However, emergence of carbapenem-resistant strains and rapid spread across all continents become a major global public health concern. In this regard, we aimed to investigate the prevalence and antibiotic resistance pattern of carbapenem-resistant Enterobacteriaceae isolated from burn patients. This retrospective cross-sectional study was conducted on patients with Burn injury for three years from March 2018 to March 2021 in a burn specialist hospital in the North of Iran. All samples were differentiated and identified by standard microbiology methods. Antimicrobial susceptibility testing was performed using the disc diffusion method on Mueller–Hinton agar according to the Clinical and Laboratory Standards Institute (CLSI) recommendations. Totally, 33 out of 127 (26%) Enterobacteriaceae samples were resistance to carbapenem (Imipenem and meropenem). Most bacteria were isolated from ICU (66.6%) and surgery (39.4%). The highest isolate of CRE was reported from surgical site infections (SSIs) with a frequency of 66.7%. The prevalence of organisms among the samples was Klebsiella spp. (75.8%), Escherichia coli (12.1%), Proteus (9.1%), and Enterobacter (3%), respectively. The antibiotic resistance pattern showed amikacin and azithromycin showed the lowest resistance with 37.5% and 20%. A recommended and successful strategy should also include the creation of new antimicrobial agents as well as the application of conventional antimicrobics.