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Intestinal Colonization Due to Carbapenem-Resistant Enterobacteriaceae Among Hematological Malignancy Patients in India: Prevalence and Molecular Charecterisation

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Abstract

Faecal carriage of Carbapenem-resistant Enterobacteriaceae (CRE) is being observed as an important risk factor for bacteremia among patients with hematological malignancies. A prospective surveillance study was conducted among these patients to determine the gut colonization of CRE. Rectal/perianal swabs were collected to isolate CRE. Carbapenem resistance was detected by disk diffusion, modified-Hodge, Carba-NP test, and PCR for blaNDM-1, blaKPC, blaOXA-48, blaVIM, blaIMP genes. A total of 209 CRE isolates were identified from 151 patients. E. coli was the most common (83.2%) CRE identified, followed by Klebsiella spp. (9.6%). The majority of CRE were observed resistant to ertapenem (86%). blaNDM-1 was the most common gene (57.3%), followed by blaOXA-48 (37.8%). 26.8% isolates found to carry both blaNDM-1 and blaOXA-48 genes. CRE is increasingly observed to cause bacteremia among hematological malignancy patients due to increased colonization. Screening for gut CRE colonization is necessary to guide empirical therapy and apply infection control measures among these patients.

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Author information

Authors and Affiliations

  1. Department of Microbiology, Nalanda Medical College, Patna, India

    Amarjeet Kumar

  2. Department of Microbiology, All India Institute of Medical Sciences, New Delhi, 110029, India

    Sarita Mohapatra, Raunak Bir, Sonu Tyagi, Hitender Gautam, Seema Sood, Bimal Kumar Das & Arti Kapil

  3. Department of Medical Oncology, Dr. B.R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India

    Sameer Bakhshi

  4. Department of Hematology, All India Institute of Medical Sciences, New Delhi, India

    Manoranjan Mahapatra

Authors
  1. Amarjeet Kumar
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  2. Sarita Mohapatra
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  3. Raunak Bir
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  4. Sonu Tyagi
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  6. Manoranjan Mahapatra
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  9. Bimal Kumar Das
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Contributions

Dr. A.K. had done the laboratory work and drafting of the manuscript. Dr. S.M. was the chief investigator, gave the concept, design of the study, and drafting of the manuscript. Dr. R.B. helped in the analysis of data. Mr. S.T. had helped in the molecular work. Dr. S.B. and Dr. M.M. had revised the manuscript critically for intellectual content. H.G. had contributed to writing the manuscript. Dr. S.S. had helped in the analysis of data. Dr. B.K.D. had revised it critically for intellectual content. Dr. A.K. had given the final approval of the version.

Corresponding author

Correspondence to Sarita Mohapatra.

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Kumar, A., Mohapatra, S., Bir, R. et al. Intestinal Colonization Due to Carbapenem-Resistant Enterobacteriaceae Among Hematological Malignancy Patients in India: Prevalence and Molecular Charecterisation. Indian J Hematol Blood Transfus 38, 1–7 (2022). https://doi.org/10.1007/s12288-021-01415-y

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