Ms. Siu Mee Janet Li1, Dr Melanie-Anne John1, Ms. Helen Ziochos1, Dr Michael W. Maley1
1NSW Health Pathology-Liverpool Hospital. Department of Microbiology & Infectious Diseases, Sydney, Australia
Biography:
Janet works at NSW Health Pathology for more than ten years on surveillance of nosocomial infections (including sepsis). Janet has twenty years experience in epidemiology and disease surveillance including chronic and communicable diseases. Janet also worked at the World Health Organization on a few missions, including SARS outbreak in HK, Polio eradication in Ghana, Avian influenza in Laos, Cholera outbreak in PNG and Measles outbreak in Fiji.
Abstract:
Background
There is a rising prevalence of Carbapenemase-producing Enterobacterales (CPE) worldwide. In order to monitor this upsurge in Southwestern Sydney, we collected data with the aim of describing the local CPE trends.
Method
We prospectively analysed the data from our clinical diagnostic laboratory for the period of 2018-2023. These isolates were also submitted to Critical Antimicrobial Resistance Alert (CARAlert) for verification. We examined the data by year, hospital, enzyme/gene type, bacterial species, specimen type, and possible source of acquisition.
Results
There is a significant rising trend of CPE over time during 2018-2023. The District quaternary referral hospital contributed the majority of the cases in Southwestern Sydney, followed by two busy metropolitan hospitals. IMP is the most common enzyme type followed by NDM and OXA-48-like. Escherichia coli is the most common species harbouring CPE, followed by Klebsiella pneumoniae. 56% of the cases were detected by screening in 2023 and 30% of the cases had a history of overseas travel or hospitalisation.
Conclusion
CPE detections are increasing in the district and may be related to overseas travel and complexity of medical care. Our results underscore an urgent need to screen for travel history at the first point of contact in the hospital and in other patients at risk for CPE to prevent further spread in our facilities and for patient safety as CPE compromises antibiotic choice in the treatment of infection.