Carbapenem resistance among clinical and environmental Gram-negative isolates recovered from hospitals in Gaza strip, Palestine.

Rida, Rawan (2017) Carbapenem resistance among clinical and environmental Gram-negative isolates recovered from hospitals in Gaza strip, Palestine. Masters thesis, الجامعة الإسلامية بغزة.

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Abstract

Background: The world is threatened by the ongoing emergence of carbapenem resistant organisms, which are contributing to increasing morbidity and mortality rates. The main objective of this study is to highlight carbapenem resistance among clinical and environmental Gram-negative bacteria (GNB) isolates. Methodology: A total of 140 clinical isolates, 150 environmental swabs, and 110 air samples were collected from Al-Shifa and The European Gaza hospitals. In addition, 70 clinical isolates were obtained from Al-Naser hospital. All isolates/samples were cultured and identified using conventional bacteriological methods. All GNB isolates were tested for their antimicrobial susceptibility using the disc diffusion method. Modified Hodge Test (MHT) was performed to investigate carbapenemsases production. Results: The overall percentage of carbapenem resistance among GNB was 12.1%. Resistance to Imipenem was 8.1% while resistance to Ertapenem and Meropenem was 3.5% and 0.8% respectively. Al-Naser hospital had the highest resistance rate (17.1%), followed by European Gaza Hospital (12.9%), while that of Al-Shifa hospital was 8.6%. The Intensive Care Units (ICUs) exhibited the highest resistance rate (52.9%), followed by the surgery departments (37.5%). Carbapenem resistance among Enterobacteriaceae was 13.2% while in Pseudomonas it was 0%. Klebsiella spp. was the most resistant to carbapenems (14.4%), followed by E. coli (9.8%). Seven isolates were positive (23.3%) for MHT. All Enterobacteriaceae isolates had a Multiple Antibiotic Resistance (MAR) index higher than 0.2. GNB was isolated from 17.2% of air samples. The ICUs recorded the highest positivity rate (26.2%). The average levels of bacteria obtained from air samples were (7.8 x 102 CFU/m3) and of fungi (5.2 x 102 CFU/m3). Environmental swabs GNB isolates were higher in European Gaza Hospital (22.1%) than Al-Shifa (7.3%). Pediatric Intensive Care Unit showed the highest positivity rate (40.9%), while Neonatal Intensive Care Unit had the lowest positivity rate (8.3%). Conclusion: The resistance found, after such a recent introduction (10 years) of carbapenems use in Gaza, shows the need for policies to prevent misuse and overuse of carbapenems, the need for infection control procedures and screening policies for carbapenem resistance on a routine basis. Keywords: Carbapenem Resistant Enterobacteriaceae (CRE), Carbapenemsases, Modified Hodge Test (MHT), Multiple Antibiotic Resistance (MAR) index

Item Type: Thesis (Masters)
Subjects: Q Science > QE Geology
Q Science > QR Microbiology
Depositing User: أ. دارين علي أحمد حمد
Date Deposited: 01 Mar 2021 11:58
Last Modified: 01 Mar 2021 11:58
URI: http://scholar.alaqsa.edu.ps/id/eprint/3890

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