{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T03:03:04Z","timestamp":1789786984015,"version":"4.0.1"},"reference-count":28,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T00:00:00Z","timestamp":1756080000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Microbial Drug Resistance"],"published-print":{"date-parts":[[2025,9,1]]},"abstract":"<jats:p>\n                    Carbapenem-resistant Enterobacterales (CRE) pose a critical threat in intensive care units (ICUs) due to rapid transmission potential and limited treatment options. The study aimed to determine the incidence of intestinal CRE colonization among ICU patients, characterize the isolates phenotypically and genotypically and identify associated risk factors. This cross-sectional study was conducted in a tertiary care hospital in North India and included 236 ICU patients. Clinical, demographic, lifestyle, and dietary data were collected through standardizedv questionnaires and medical records. CRE isolates were identified using standard microbiological techniques and characterized for resistance genes. CRE colonization was detected in 69.07% of patients.\n                    <jats:italic toggle=\"yes\">Escherichia coli<\/jats:italic>\n                    (74.15%) and\n                    <jats:italic toggle=\"yes\">Klebsiella pneumoniae<\/jats:italic>\n                    (21.61%) were the predominant species, with a significant rise in\n                    <jats:italic toggle=\"yes\">K. pneumoniae<\/jats:italic>\n                    colonization during ICU stays (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    = 0.049), suggesting nosocomial transmission. Asthma emerged as a novel independent risk factor (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    = 0.023, 100% colonization). Other significant associations included non-vegetarian diet (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    = 0.02), prolonged ICU stay (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    = 0.010), and prior broad-spectrum antibiotic use (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    = 0.028). Molecular analysis showed 84% of CRE isolates harbored the bla\n                    <jats:sub>NDM-1<\/jats:sub>\n                    gene, while bla\n                    <jats:sub>IMP<\/jats:sub>\n                    was absent. CRE colonization was significantly associated with higher mortality (38.0% vs. 23.3%,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    = 0.026). The study reveals a high prevalence of intestinal CRE colonization among ICU patients and highlights key modifiable risk factors and regional resistance patterns. Routine rectal screening, stringent infection control, and robust antimicrobial stewardship are urgently needed to limit CRE spread. A deeper understanding of colonization dynamics is essential to improving outcomes in critically ill patients.\n                  <\/jats:p>","DOI":"10.1177\/10766294251366395","type":"journal-article","created":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T17:09:57Z","timestamp":1759943397000},"page":"279-286","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Carbapenem-Resistant Enterobacterales in Indian ICU Patients: Molecular Insights, Risk Factors, and Clinical Impact"],"prefix":"10.1177","volume":"31","author":[{"given":"Mukesh Kumar","family":"Patwa","sequence":"first","affiliation":[{"name":"Department of Microbiology, King George's Medical University, Lucknow, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1766-4850","authenticated-orcid":false,"given":"Sheetal","family":"Verma","sequence":"additional","affiliation":[{"name":"Department of Microbiology, King George's Medical University, Lucknow, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vimala","family":"Venkatesh","sequence":"additional","affiliation":[{"name":"Department of Microbiology, King George's Medical University, Lucknow, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saurabh","family":"Kashyap","sequence":"additional","affiliation":[{"name":"Department of Community Medicine and Public Health, King George's Medical University, Lucknow, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"family":"Mohit","sequence":"additional","affiliation":[{"name":"Department of Microbiology, King George's Medical University, Lucknow, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zia","family":"Arshad","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Critical Care, King George's Medical University, Lucknow, India."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,8,25]]},"reference":[{"key":"e_1_3_7_2_2","unstructured":"World Health Organization. WHO updates list of drug-resistant bacteria most threatening to human health. May 17 2024. Available from: https:\/\/www.who.int\/news\/item\/17-05-2024-who-updates-list-of-drug-resistant-bacteria-most-threatening-to-human-health [Last accessed: February24 2025]."},{"key":"e_1_3_7_3_2","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2022.823684"},{"key":"e_1_3_7_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.iccn.2023.103491"},{"key":"e_1_3_7_5_2","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2022.894341"},{"key":"e_1_3_7_6_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0041-1732494"},{"key":"e_1_3_7_7_2","doi-asserted-by":"publisher","DOI":"10.4266\/acc.2021.00409"},{"key":"e_1_3_7_8_2","volume-title":"Performance Standards for Antimicrobial Susceptibility Testing. 32nd ed. CLSI supplement M100","author":"Clinical and Laboratory Standards Institute (CLSI)","year":"2022","unstructured":"Clinical and Laboratory Standards Institute (CLSI). Performance Standards for Antimicrobial Susceptibility Testing. 32nd ed. CLSI supplement M100. Clinical and Laboratory Standards Institute; 2022."},{"key":"e_1_3_7_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/0003-2697(81)90473-5"},{"key":"e_1_3_7_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw856"},{"key":"e_1_3_7_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2023.12.002"},{"key":"e_1_3_7_12_2","doi-asserted-by":"publisher","DOI":"10.1080\/21505594.2016.1222343"},{"key":"e_1_3_7_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiw282"},{"key":"e_1_3_7_14_2","first-page":"45","article-title":"Risk factors and outcomes of carbapenem-resistant Enterobacteriaceae colonization and infections in trauma patients","volume":"15","author":"Sharma A","year":"2023","unstructured":"Sharma A, , Grover N, , Arora S, et al. Risk factors and outcomes of carbapenem-resistant Enterobacteriaceae colonization and infections in trauma patients. J Lab Physicians, 2023; 15:45\u201351.","journal-title":"J Lab Physicians"},{"key":"e_1_3_7_15_2","first-page":"632","article-title":"Carbapenem-resistant Enterobacteriaceae colonization in intensive care units: Prevalence and risk factors","volume":"22","author":"Rajni E","year":"2018","unstructured":"Rajni E, , Gupta S, , Kumar S, et al. Carbapenem-resistant Enterobacteriaceae colonization in intensive care units: Prevalence and risk factors. Indian J Crit Care Med, 2018; 22:632\u2013637.","journal-title":"Indian J Crit Care Med"},{"key":"e_1_3_7_16_2","first-page":"573","article-title":"Risk factors, clinical presentation, and outcomes of infections due to carbapenem-resistant Enterobacteriaceae in a tertiary care hospital in North India","volume":"21","author":"Mohan B","year":"2017","unstructured":"Mohan B, , Prasad A, , Kaur H, et al. Risk factors, clinical presentation, and outcomes of infections due to carbapenem-resistant Enterobacteriaceae in a tertiary care hospital in North India. Indian J Crit Care Med, 2017; 21:573\u2013578.","journal-title":"Indian J Crit Care Med"},{"key":"e_1_3_7_17_2","first-page":"60","article-title":"Risk factors for carbapenem-resistant Enterobacteriaceae colonization in hospitalized patients: A prospective study","volume":"36","author":"Kumar A","year":"2018","unstructured":"Kumar A, , Gupta R, , Nag VL. Risk factors for carbapenem-resistant Enterobacteriaceae colonization in hospitalized patients: A prospective study. Indian J Med Microbiol, 2018; 36:60\u201366.","journal-title":"Indian J Med Microbiol"},{"key":"e_1_3_7_18_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-018-3390-4"},{"key":"e_1_3_7_19_2","first-page":"57","article-title":"Risk factors for carbapenem-resistant Enterobacteriaceae acquisition among adults: A case-control study","volume":"7","author":"Ramanathan Y","year":"2018","unstructured":"Ramanathan Y, , Swaminathan S, , Kumar S, et al. Risk factors for carbapenem-resistant Enterobacteriaceae acquisition among adults: A case-control study. Antimicrob Resist Infect Control, 2018; 7:57.","journal-title":"Antimicrob Resist Infect Control"},{"key":"e_1_3_7_20_2","doi-asserted-by":"publisher","DOI":"10.1128\/aac.00216-22"},{"key":"e_1_3_7_21_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-016-2710-0"},{"key":"e_1_3_7_22_2","first-page":"14","article-title":"Factors associated with carbapenem-resistant Enterobacteriaceae in patients admitted to a tertiary care hospital in Mumbai, India","volume":"64","author":"Saseedharan S","year":"2016","unstructured":"Saseedharan S, , Sahu M, , Chaddha R, et al. Factors associated with carbapenem-resistant Enterobacteriaceae in patients admitted to a tertiary care hospital in Mumbai, India. J Assoc Physicians India, 2016; 64:14\u201318.","journal-title":"J Assoc Physicians India"},{"key":"e_1_3_7_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2021.106439"},{"key":"e_1_3_7_24_2","first-page":"32","article-title":"Phenotypic and molecular characterization of carbapenem-resistant Enterobacteriaceae in a tertiary care hospital in Delhi, India","volume":"34","author":"Mittal G","year":"2016","unstructured":"Mittal G, , Gaind R, , Kumar D, et al. Phenotypic and molecular characterization of carbapenem-resistant Enterobacteriaceae in a tertiary care hospital in Delhi, India. Indian J Med Microbiol, 2016; 34:32\u201337.","journal-title":"Indian J Med Microbiol"},{"key":"e_1_3_7_25_2","first-page":"457","article-title":"Polymyxins: Antimicrobial susceptibility concerns and therapeutic options","volume":"37","author":"Balaji V","year":"2019","unstructured":"Balaji V, , Jeremiah SS, , Baliga PR. Polymyxins: Antimicrobial susceptibility concerns and therapeutic options. Indian J Med Microbiol, 2019; 37:457\u2013464.","journal-title":"Indian J Med Microbiol"},{"key":"e_1_3_7_26_2","first-page":"812418","article-title":"Emergence of colistin resistance and mcr genes in carbapenem-resistant Enterobacteriaceae in Henan Province","volume":"13","author":"Yuan Y","year":"2022","unstructured":"Yuan Y, , Li Y, , Wang G, et al. Emergence of colistin resistance and mcr genes in carbapenem-resistant Enterobacteriaceae in Henan Province. China. Front Microbiol, 2022; 13:812418.","journal-title":"China. Front Microbiol"},{"key":"e_1_3_7_27_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000001028"},{"key":"e_1_3_7_28_2","first-page":"258","article-title":"Risk factors for infection with metallo-\u03b2-lactamase-producing Klebsiella pneumoniae after exposure to imipenem or colistin","volume":"57","author":"Papadimitriou-Olivgeris M","year":"2013","unstructured":"Papadimitriou-Olivgeris M, , Marangos M, , Fligou F, et al. Risk factors for infection with metallo-\u03b2-lactamase-producing Klebsiella pneumoniae after exposure to imipenem or colistin. Antimicrob Agents Chemother, 2013; 57:258\u2013262.","journal-title":"Antimicrob Agents Chemother"},{"key":"e_1_3_7_29_2","doi-asserted-by":"publisher","DOI":"10.1111\/lam.13384"}],"container-title":["Microbial Drug Resistance"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10766294251366395","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10766294251366395","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10766294251366395","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T01:20:32Z","timestamp":1777684832000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10766294251366395"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,25]]},"references-count":28,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2025,9,1]]}},"alternative-id":["10.1177\/10766294251366395"],"URL":"https:\/\/doi.org\/10.1177\/10766294251366395","relation":{},"ISSN":["1076-6294","1931-8448"],"issn-type":[{"value":"1076-6294","type":"print"},{"value":"1931-8448","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,25]]}}}