Fecal Carriage and Epidemiology of Carbapenem-Resistant Enterobacteriaceae Among Hospitalized Patients in a University Hospital

Figures & data

Table 1 Antimicrobial Susceptibility of Carbapenem-Resistant Enterobacteriacae Isolated from Fecal Samples

Antimicrobial	K. Pneumoniae, n=42			E. Coli, n=7			Other Species, n=11			Total, n=60
	R,n (%)	I, n (%)	S, n (%)	R, n (%)	I, n (%)	S, n (%)	R,n (%)	I, n (%)	S, n (%)	R,n (%)	I, n (%)	S, n (%)
Ampicillin	100(42)	0(0)	0(0)	100(7)	0(0)	0(0)	100(11)	0(0)	0(0)	100(60)	0(0)	0(0)
Amoxicillin/clavulanic	100(42)	0(0)	0(0)	100(7)	0(0)	0(0)	100(11)	0(0)	0(0)	100(60)	0(0)	0(0)
Piperacillin/tazobactam	95.2(40)	2.4(1)	2.4(1)	100(7)	0(0)	0(0)	81.8(9)	9.1(1)	9.1(1)	93.4(56)	3.3(2)	3.3(2)
Cefazolin	100(42)	0(0)	0(0)	100(7)	0(0)	0(0)	100(11)	0(0)	0(0)	100(60)	0(0)	0(0)
Cefoxitin	100(42)	0(0)	0(0)	100(7)	0(0)	0(0)	90.9(10)	9.1(1)	0(0)	98.3(59)	1.7(1)	0(0)
Ceftriaxone	100(42)	0(0)	0(0)	100(7)	0(0)	0(0)	100(11)	0(0)	0(0)	100(60)	0(0)	0(0)
Cefepime	100(42)	0(0)	0(0)	100(7)	0(0)	0(0)	90.9(10)	0(0)	9.1(1)	98.3(59)	1.7(1)	0(0)
Aztreonam	95.2(40)	0(0)	4.8 (2)	100(7)	0(0)	0(0)	90.9(10)	0(0)	9.1(1)	95.0(57)	0(0)	5.0(3)
Ertapenem	100(42)	0(0)	0(0)	100(7)	0(0)	0(0)	100(11)	0(0)	0(0)	100(60)	0(0)	0(0)
Meropenem	100(42)	0(0)	0(0)	71.4(5)	14.3(1)	14.3(1)	90.9(10)	9.1(1)	0(0)	95.0(57)	3.3(2)	1.7(1)
Imipenem	95.2(40)	0(0)	4.8(2)	71.4(5)	0(0)	28.6(2)	81.8(9)	9.1(1)	9.1(1)	90.0(54)	1.7(1)	8.3(5)
Amikacin	71.4(30)	0(0)	28.6(12)	14.3(1)	14.3(1)	71.4 (5)	54.5(6)	0(0)	45.5(5)	61.6(37)	1.7(1)	36.7(22)
Gentamicin	83.3(35)	2.4(1)	14.3(6)	42.9(3)	0(0)	57.1(4)	81.8(9)	0(0)	18.2(2)	78.3(47)	1.7(1)	20.0(12)
Tobramycin	76.2(32)	9.5(4)	14.3(6)	42.8 (3)	28.6(2)	28.6(2)	54.5(6)	27.3(3)	18.2(2)	68.3(41)	15.0(9)	16.7(10)
Ciprofloxacin	80.9(34)	4.8(2)	14.3(6)	85.7(6)	0(0)	14.3(1)	81.8(9)	0(0)	18.2(2)	81.7(49)	3.3(2)	15.0(9)
Levofloxacin	81.0(34)	0(0)	19.0(8)	85.7(6)	0(0)	14.3(1)	45.4(5)	27.3(3)	27.3(3)	75.0(45)	5.0(3)	20.0(12)
Tigecycline	16.7(7)	–	83.3(35)	0(0)	–	100(7)	18.2(2)	–	81.8(9)	15.8(9)	–	85.0(51)
Notrofurantoin	90.5(38)	7.1(3)	2.4(1)	14.2(1)	42.9(3)	42.9(3)	36.4(4)	27.2(3)	36.4(4)	71.7(43)	15.0(9)	13.3(8)
Trimethoprim/sulfamethoxazole	14.3(6)	0(0)	85.7(36)	57.1(4)	0(0)	42.9(3)	72.7(8)	0(0)	27.3(3)	30.0(18)	0(0)	70.0(42)
Colistin	0(0)	–	100(42)	0(0)	–	100(7)	0(0)	–	100(11)	0(0)	–	100(60)

Abbreviations: R, Resistant; I, Intermediate; S, Susceptible.

Table 2 Molecular Characteristics of Carbapenem-Resistant Enterobacteriacae Isolated from Fecal Samples

Isolates	Number (%)	Carbapenemase Phenotypic Confirmatory Test Positive (n)	Carbapenemase Gene						MCR-1
			KPC	NDM	IMP	VIM	OXA48	Other
K. pneumoniae^a	42(70)	41	35	1	5	–	–	1	–
E. coli	7(11.6)	5	2	3	–	–	–	–	–
K. oxytoca^b	3(5.0)	3	1	2	1	–	–	–	–
C. freundii^c	3(5.0)	3	1	3	–	–	–	–	–
E. cloacae	3(5.0)	2	–	2	–	–	–	–	–
E. aerogenes	1(1.7)	0	–	–	–	–	–	–	–
R. planticola	1(1.7)	1	–	1	–	–	–	–	–
Total	60(100)	55	39	12	6	0	0	1	0

Notes: ^aOne K. pneumoniae coproducing KPC and IMP. ^bOne K.oxytoca coproducing NDM and IMP. ^cOne C. freundii coproducing NDM and KPC.

Figure 1 The Xbal PFGE-based dendrogram for the 40 carbapenemase-producing Klebsiella penumoniae isolates. A,B,C,D,E,F,G,H, and I represent nine different PFGE clusters identified at a similarity index of 85%.