From the Research
Carbapenem-Resistant Enterobacteriaceae (CRE) fecal carriage rates in India are approximately 6.1% in healthy individuals and 18.1% in hospitalized patients, with the most common CRE species being Klebsiella pneumoniae and Escherichia coli, and NDM-1 being the predominant resistance mechanism, as reported in recent studies 1, 2.
Key Findings
- The prevalence of CRE fecal carriage varies significantly by region, with higher rates in urban areas and tertiary care hospitals.
- Risk factors for CRE colonization include recent hospitalization, antibiotic exposure, invasive procedures, and prolonged ICU stays.
- Patients colonized with CRE have a higher risk of developing subsequent infections with limited treatment options.
- Effective infection control measures, including active surveillance, contact precautions, antimicrobial stewardship, and improved sanitation, are essential to reduce CRE transmission in Indian healthcare facilities.
Recent Studies
- A 2022 study published in the Indian Journal of Medical Microbiology found that the fecal carriage rate of carbapenemase-producing Enterobacteriaceae in healthy Indian subjects was 6.1% 1.
- A 2017 study published in the Indian Journal of Medical Microbiology found that the gut carriage rate of CRE in hospitalized patients was 18.1% 2.
Molecular Epidemiology
- The most common CRE species identified in Indian patients include Klebsiella pneumoniae and Escherichia coli, with NDM-1 being the predominant resistance mechanism 2, 1.
- The molecular epidemiology of CRE in India is characterized by a diverse range of sequence types, with ST11 being a dominant strain in Klebsiella pneumoniae 3.
Recommendations
- Regular CRE screening for hospitalized patients, particularly those with liver disease or other high-risk conditions, should be conducted to limit the spread of CRE strains 3.
- Effective infection control measures, including active surveillance, contact precautions, antimicrobial stewardship, and improved sanitation, are essential to reduce CRE transmission in Indian healthcare facilities 2, 1.