Clinical Microbiology and Antimicrobial Chemotherapy. 2024; 26(3):345-355
To investigate the prevalence of carbapenemase-encoding genes carriage in patients at hospital admission.
The prospective single-center cross-sectional study was performed in Moscow Multidisciplinary Clinical Center «Kommunarka» from 15.09.2022 till 15.08.2023. Adult patients without signs of gastrointestinal, upper and lower respiratory tract infections were included to research at fist 24 hour after hospital admission. Rectal swab and oropharyngeal swab were collected from each patient. Additional lower respiratory tract samples were collected from patients who were undergoing mechanical ventilation. The collected samples were tested by polymerase chain reaction using AmpliSens reagent kits to identify crabapenemase-encoding genes: blaOXA-58, blaOXA-51, blaOXA-40, blaOXA-23, blaVIM, blaIMP, blaOXA-48, blaNDM and blaKPC.
A total of 737 patients aged 18 to 94 were included, 442 of them were females and 295 were males. Carriage of genes in at least one locus was found in 12.6% of patients. 70.9% of patients carried only one type of genes, but 16.1% carried two different types of genes and 12.9% carried from 3 to 6 different types of genes. Males were carriers more often, then females (18.3% and 8.6% respectively). The most common gene was blaOXA-48 (23.1%), followed by blaNDM (15.4%). Genes blaKPC and blaOXA-51 were detected with the same frequency (14.7%). The other genes were less common, from 0.6% (blaIMP) to 10.3% (blaOXA-51). Genes blaOXA-48, blaNDM and blaKPC were more common in rectal swabs, and blaOXA-58 and blaOXA-51 predominated in upper respiratory tract samples. In lower respiratory tract samples blaOXA-48, blaKPC and blaOXA-51 occurred with equal frequency. In ICU patients the prevalence of carriage was 35.1% compared to 8.5% among ward patients. The carriage rate was the highest among patients from therapeutic wards (17.5%) and the lowest in patients from hematology wards (3.0%).
Our study is one of the first in Russia to evaluate the prevalence of community-acquired carriage of carbapenemase genes. The features we discovered have potential clinical significance and allow us to draw some conclusions for our center, but multicenter studies of a similar design are needed to identify general patterns.