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Community prevalence of carbapenemase-producing organisms in East London

Henderson, J.; Ciesielczuk, H.; Nelson, S. M.; Wilks, M.

Authors

J. Henderson

H. Ciesielczuk

M. Wilks



Abstract

Background: Over the last decade there has been a rapid, worldwide increase in carbapenem resistance, which is of growing concern. The main protagonists, the carbapenemases Klebsiella pneumoniae carbapenemase (KPC), oxacillinase β-lactamase 48 (OXA-48), imipenemase metallo-β-lactamase (IMP), Verona integron-borne metallo-β-lactamase (VIM), and New Delhi metallo-β-lactamase (NDM) have also been reported across the UK. However, these reports are derived from a combination of reactive screening, outbreak control, inpatient surveillance, and diagnostic samples. Therefore, the true community prevalence is unknown. Aim: To determine the community prevalence of carbapenemase-producing organisms (CPOs) in the area served by Barts Health NHS Trust. Methods: Active screening of 200 non-duplicate community stool samples was performed. Patient demographics and foreign travel history were extracted from the laboratory information management system to identify potential risk factors for carriage of CPOs. Findings: Patients in this study were aged from one to 93 years and were evenly distributed between male and female. Foreign travel in the last year was listed for 46 out of 200 (23%) patients, with the most commonly visited countries including Bangladesh (4%), India (2.5%), Morocco (2%), and Turkey (1.5%). However, only one patient tested positive for a CPO, an NDM-producing Pseudomonas aeruginosa, and this patient had travelled to the Caribbean. Conclusion: To date, there have been no studies investigating the prevalence of CPOs in the UK community. Given the high-risk patient population served by Barts Health NHS Trust, it is reassuring that the prevalence observed here was low. However, it should be highlighted that travel to countries not previously categorized as high risk may also pose a threat.

Journal Article Type Article
Publication Date 2019-10
Journal Journal of Hospital Infection
Print ISSN 0195-6701
Electronic ISSN 1532-2939
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 103
Issue 2
Pages 142-146
APA6 Citation Henderson, J., Ciesielczuk, H., Nelson, S. M., & Wilks, M. (2019). Community prevalence of carbapenemase-producing organisms in East London. Journal of Hospital Infection, 103(2), 142-146. https://doi.org/10.1016/j.jhin.2019.04.014
DOI https://doi.org/10.1016/j.jhin.2019.04.014
Keywords carbapenemase, prevalence, community, screening, surveillance
Publisher URL https://doi.org/10.1016/j.jhin.2019.04.014
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