# Detection of the blaNDM-1 Gene in Carbapenem-Resistant Enterobacterales Causing Urinary Tract Infections in Patients at a Rural Teaching Hospital

## TL;DR

This study found the blaNDM-1 gene in carbapenem-resistant bacteria causing UTIs at a rural hospital, highlighting the growing threat of antibiotic resistance.

## Contribution

The detection of blaNDM-1 in CRE isolates from UTIs in a rural setting adds to the understanding of antibiotic resistance spread.

## Key findings

- Out of 555 Enterobacterales isolates, 47 (8.5%) were confirmed as carbapenem-resistant.
- 28 out of 47 carbapenem-resistant isolates tested positive for the blaNDM-1 gene.

## Abstract

Background: Carbapenem-resistant Enterobacterales (CRE) pose a significant public health threat due to their resistance to last-line antibiotics. Urinary tract infections (UTIs) caused by multidrug-resistant organisms have become a major challenge in clinical settings. The spread of CRE is largely attributed to the acquisition of carbapenemase-encoding genes, horizontal gene transfer, and overuse of broad-spectrum antibiotics.

Methodology: A total of 9235 urine samples were analyzed, and more than 105 CFU/mL bacterial count was considered positive for UTI. These bacteria were identified and further screened for CRE and blaNDM-1 genes.

Results: A total of 9235 urine samples were analyzed, out of which 555 were identified as Enterobacterales. Among these, 47 were confirmed as CRE, accounting for 8.5% of the Enterobacterales isolates. Out of 47 CRE, 28 were positive for the blaNDM-1 gene.

Conclusions: The study highlights the increasing burden of CRE and the urgent need for stringent antimicrobial stewardship, effective infection control measures, and the development of new therapeutic strategies to combat MDR infections. Additionally, risk factors associated with CRE infections, their implications on public health, and potential future therapeutic approaches are discussed.