The prevalence and antibiotic susceptibility pattern of carbapenem-resistant Enterobacteriaceae in an Iranian burn center

Carbapenems are a class of β-lactam antibiotics that are commonly used to treat multidrug-resistant (MDR) Gram-negative bacteria. However, the emergence of carbapenem-resistant strains and rapid spread across all continents become a major public health concern. In this regard, we aimed to investigate the prevalence and antibiotic resistance pattern of carbapenem-resistant Enterobacteriaceae (CRE) in an Iranian burn center. This retrospective cross-sectional study was performed during three years from March 2018 to March 2021 on burn victims who referred to a burn specialist hospital in the North of Iran. All bacterial isolates were differentiated and confirmed by standard microbiology methods. Disc diffusion method was applied to determine the antibiotic susceptibility pattern. CRE was defined as an isolate resistant to imipenem or/and meropenem. Totally, 33 out of 127 (26%) Enterobacteriaceae samples were resistance to carbapenem. Also, 66.7% of CRE were isolated from ICU and 33.3% from surgery ward. The majority of CRE (66.7%) was associated with surgical site infections (SSIs). The most prevalent CRE among the clinical samples was Klebsiella spp. (75.8%), followed by Escherichia coli (12.1%), Proteus spp. (9.1%), and Enterobacter spp. (3%), respectively. The antibiotic susceptibility pattern showed amikacin with 53.3% susceptibility as the most effective agents against CRE isolates. Despite the low level of CRE in our study, the high level of drug resistance among these isolates necessitating the use of unique infection control strategies and rigorous adherence to these guidelines.