The effect of first-line TB treatment on carbapenem resistance in faecal Enterobacterales

Abstract

Carbapenems are used more regularly as empiric and targeted treatment options due to the emergence of resistant bacteria. There is an increased risk of mortality and treatment cost in cases where carbapenem resistant Enterobacterales (CRE) have been isolated. This is due to the fact that remaining therapeutic options are limited, potentially toxic and expensive. Antibiotic use is a risk factor for colonisation with resistant bacteria such as carbapenem resistant Enterobacterales (CRE) and carbapenemase-producing Enterobacterales (CPE). Tuberculosis treatment specifically has not been evaluated as a risk factor for CRE colonisation in the literature. This study aimed to determine whether patients receiving tuberculosis (TB) treatment are likely to be colonised with CRE two weeks after treatment is commenced by collecting a rectal swab before treatment commences and again two weeks after first line treatment starts. Each collected swab was screened using culture CARBA-R screening plate and the results evaluated. Although no CRE was isolated in these 18 patients, due to the small sample size, the possibility cannot be excluded. A future study sampling a larger patient group, with additional sampling time points later in the treatment regimen will be valuable to detect subsequent CPE / CRE colonisation in the population receiving TB treatment.