title: Carriage prevalence of carbapenem-resistant Enterobacteriaceae in stool samples: A surveillance study.
abstract: BACKGROUND
  With more people being exposed to antibiotics, intestinal microflora faces constant pressure of antibiotic selection, which has resulted in the emergence of multidrug resistant strains. This may pose a severe problem as intestinal Enterobacteriaceae members are commonly implicated in human infections.
  
  
  OBJECTIVE
  This surveillance study was undertaken to investigate the carriage of carbapenem-resistant Enterobacteriaceae (CRE) in the gastrointestinal tract among patients attending the outpatient clinic in a tertiary care center of East Delhi, India.
  
  
  METHODS
  We performed a prospective surveillance study to screen 242 Enterobacteriaceae isolates for carbapenemase production from the stool samples of 123 outpatients attending a tertiary care hospital in East Delhi over a four-month period.
  
  
  RESULTS
  Twenty-four (9.9 per cent) isolates demonstrated carbapenemase activity among 242 screened Enterobacteriaceae isolates. Four stool samples had two isolates of different species, both eliciting this feature and therefore indicating presence of multiple carbapenem-resistant Enterobacteriaceae (CRE) isolates in a single sample.
  
  
  CONCLUSIONS
  Screening for carriage of CRE in stools of patients undergoing elective or emergency gastrointestinal surgical procedures, with haematological malignancies taking chemotherapy, or those planned for bone marrow transplantation can guide clinicians about gut colonisation of multidrug-resistant Enterobacteriaceae as these groups of patients are at risk of possible endogenous infection.
authors.affiliation: University College of Medical Sciences and Guru Teg Bahadur Hospital , Dilshad Garden, India.
authors.forename: Sumit
authors.initials: S
authors.lastname: Rai
authors.affiliation: University College of Medical Sciences and Guru Teg Bahadur Hospital , Dilshad Garden, India.
authors.forename: Dipmala
authors.initials: D
authors.lastname: Das
authors.affiliation: University College of Medical Sciences and Guru Teg Bahadur Hospital , Dilshad Garden, India.
authors.forename: Devendra Kumar
authors.initials: DK
authors.lastname: Niranjan
authors.affiliation: University College of Medical Sciences and Guru Teg Bahadur Hospital , Dilshad Garden, India.
authors.forename: Narendra Pal
authors.initials: NP
authors.lastname: Singh
authors.affiliation: University College of Medical Sciences and Guru Teg Bahadur Hospital , Dilshad Garden, India.
authors.forename: Iqbal R
authors.initials: IR
authors.lastname: Kaur
keywords: Carbapenem resistant Enterobacteriaceae; gut colonisation; prophylactic antibiotic