Methods: The study was performed between 1 March and 15 May 2015. Rectal swabs were collected from every patient with positive clinical sample as well as the other cases in the same room/ICU. All positive cases were sampled weekly until discharge or death. The swabs were inoculated into 10 ml trypticase soy broth (bioMerieux, TSB) with addition of one 10 microgram ertapenem disk (Oxoid, UK) and incubated at 35oC for 18-20 hours. Next day, after vortexing, 100 microliter of the inoculum was subcultured onto chromID CARBA agar plates (biomerieux, France) and incubated at 35oC for 18-20 hours. Suspected CRE colonies on chrom ID CARBA (blue/green to blue/grey colored) were identified to species level by the VITEK MS (biomerieux, France). Antimicrobial susceptibility testing of the isolates identified were performed by the VITEK 2 system. Isolates were tested for their resistance phenotypes to imipenem, ertapenem and meropenem by the E-test (biomerieux, France). The results were interpreted according to the EUCAST criteria.
Results: A total of 32 cases (17 deep tracheal aspirate, 10 blood, 8 urine, 2 tissue bx, 1 drain fluid) had CRE from clinical samples. Of these 25 (78%) had rectal CRE carriage. Rectal colonization was also positive in 21 of the screened cases. All these strains were resistant to meropenem and imipenem. Of the overall infected and/or colonized cases 26 were female and mean age was 60.4 (min:1 max:91). RS+ cases had a median of 3 weekly RS samples (Range 1-13). Of the 46 colonized cases, 7 had negative (3 of the 25 infected and 4 of the only RS colonized cases, p>0.05) RS culture on the follow up. Three cases had negative RS on the first week whereas the others had results had been negative on the 2nd, 3rd, 6th and 8thweek. Three cases had only one negative result while three had two and one had 4 consecuive negative results.
Conclusion: About 80% of the cases with CRE+ clinical samples are also rectal carriers and 15% of them become negative on follow up.
B. Arda, MSD: Speaker's Bureau , Speaker honorarium
A. Uyan, None
M. Erdinc, None
D. Dikis, None
N. B. Korkmaz, None
N. Deniz-Kucukler, None
N. Kepeli, None
B. Ulusoy, None
S. A. Barik, None
M. Ozinel, None
S. Ulusoy, MSD: Speaker's Bureau , Speaker honorarium
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