Prevalence of Carbapenem-Resistant Enterobacteriaceae (CRE) And Control Measures to Prevent The Spread of Infections in Patients across Trat Hospital

Abstract

At present, the increasing prevalence of Carbapenem-resistant Enterobacteriaceae (CRE) has become a serious problem in many countries around the world including Thailand. The objectives of this study is to investigate the prevalence of Carbapenem-resistant Enterobacteriaceae (CRE) isolated from patients in Trat Hospital during 1st January 2014 to 31^st December 2018. A total of 5,311 isolates of Enterobacteriaceae were determined the antimicrobial susceptibility by Kirby-Bauer disc diffusion using Carbapenems (Imipenem or Meropenem). The frequency of CRE in 2014 to 2018 were constantly increasing with 0.11 %, 1.27 %, 2.50 % and 3.45 %, respectively. Interestingly, the frequency of Carbapenem-resistant Escherichia coli was dramatically increased from 1.99 % in 2016 to 4.82 % in 2017. The small epidemic of Carbapenem-resistant E. coli was found in MED and ICU which these isolates had the same antimicrobial resistance pattern. Accordingly, the spread of CRE might be caused by a medical facility, medical staff or medical equipment. Later, Trat hospital has reviewed the control measures and improved the understanding of the guidelines to prevent and control the spread of CRE in the hospital includingisolation of patients, separation of equipments, strictly contact precautions, campaign for rational drug use and CRE notification system of laboratory. These actions could lead to the decreasing in the frequency of CRE in Trat hospital to be 2.30 % of isolates in 2018. This study provided useful information to consider an appropriate antimicrobial treatment in infectious diseases and to improve the effective control measures to prevent the spread of antimicrobial resistance in the hospital.