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<p>Carbapenemase-producing carbapenem-resistant Enterobacterales (CP-CRE) transmission studies incorporating clinical and genomic data from hospitals in India are lacking. We prospectively enrolled surgical intensive care unit (SICU) patients in a tertiary-care hospital in India (July 29 to November 30, 2023) and collected peri-rectal swabs at SICU admission, SICU discharge, and hospital discharge, alongside SICU environmental sampling. CP-CRE isolates were whole-genome sequenced to investigate differences between community-acquired (CA), healthcare-associated (HCA), hospital-acquired (HA), and environmental isolates. Twenty-seven percent of participants were CP-CRE-colonized on SICU admission, with risk factors of previous hospitalization and exposure to ≥2 antimicrobials. Among 148 admission-negative patients, 115 had repeat PRS; 42 (36.5%) acquired CP-CRE (27 upon SICU discharge, 15 upon hospital discharge). <i>bla</i><sub>NDM</sub> (84%, <i>n</i> = 103) and <i>bla</i><sub>OXA</sub> (29%, <i>n</i> = 36) carbapenemase genes were present in the sequenced isolates; 20 isolates (16%) carried both. Highly similar <i>E. coli</i> and <i>K. pneumoniae</i> clusters suggest hospital transmission, although the sample size limited network inference.</p>

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Carbapenemase-producing carbapenem-resistant Enterobacterales in surgical intensive care unit patients in a tertiary hospital in India

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月22日

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  • Lindsey R. Hall,
  • Emily E. Benedict,
  • Fabia Edathadathil,
  • Jobin J. Jacob,
  • Devendhu Suresh,
  • Yathu Krishna,
  • Juby A. Varghese,
  • Jacaranda van Rheenen,
  • Ige A. George,
  • Jennie H. Kwon,
  • Margaret A. Olsen,
  • Anil Kumar Vasudevan,
  • Emily E. Petersen,
  • Matthew Westercamp,
  • Surbhi Leekha,
  • Gautam Dantas,
  • Balaji Veeraraghavan,
  • Sudheer O. Vayoth,
  • Sanjeev K. Singh,
  • David K. Warren,
  • Sumanth Gandra

摘要

Carbapenemase-producing carbapenem-resistant Enterobacterales (CP-CRE) transmission studies incorporating clinical and genomic data from hospitals in India are lacking. We prospectively enrolled surgical intensive care unit (SICU) patients in a tertiary-care hospital in India (July 29 to November 30, 2023) and collected peri-rectal swabs at SICU admission, SICU discharge, and hospital discharge, alongside SICU environmental sampling. CP-CRE isolates were whole-genome sequenced to investigate differences between community-acquired (CA), healthcare-associated (HCA), hospital-acquired (HA), and environmental isolates. Twenty-seven percent of participants were CP-CRE-colonized on SICU admission, with risk factors of previous hospitalization and exposure to ≥2 antimicrobials. Among 148 admission-negative patients, 115 had repeat PRS; 42 (36.5%) acquired CP-CRE (27 upon SICU discharge, 15 upon hospital discharge). blaNDM (84%, n = 103) and blaOXA (29%, n = 36) carbapenemase genes were present in the sequenced isolates; 20 isolates (16%) carried both. Highly similar E. coli and K. pneumoniae clusters suggest hospital transmission, although the sample size limited network inference.