Online ISSN 2313-1519
Print    ISSN 1812-2892
Abstract - Measures for infection control in a Carbapenam-resistant Enterobacteriae carrier post open heart surgery in the cardiac intensive care unit: A case report
Gurpreet Singh, Simon Jerome Vendargon, Syed Rasul G. Syed Hamid, Masliza Zaid



The prevalence of Carbapenem-resistant Enterobacteriaceae infection in a hospital setting is on the rise. Once infected, it is associated with increased morbidity as well as mortality. The common isolates of a Carbapenem-resistant Enterobacteriaceae infection is Klebsiella pneumoniae. In this case report, we discussed on a patient who is a Carbapenem-resistant Enterobacteriaceae carrier that underwent an open heart surgery in a government hospital in Johor Bahru, Malaysia. On the whole, our objectives were to identify risk factors that warrants a patient to be screened for Carbapenem-resistant Enterobacteriaceae infection and once a Carbapenem-resistant Enterobacteriaceae infected patient is detected, what are the measures that can be implemented to prevent and  control spread of infection particularly in the intensive care unit setting.

Key words: Carbapenem-resistant Enterobacteriaceae, open heart surgery, intensive care unit, infection control

Corresponding author: Gurpreet Singh, Department of Cardiothoracic Surgery, Hospital Sultanah Aminah, Johor Bahru, Malaysia. E-mail:




1. Malaysian action plan on antimicrobial resistance (MyAP-AMR) 2017-2021, Ministry of Health Malaysia, 2018.

2. Salsano A, Giacobbe DR, Sportelli E, Olivieri GM, Brega C, Coppo E et al. Risk factors for infections due to carbapenem-resistant Klebsiella pneumoniae after open heart surgery. Interactive CardioVascular and Thoracic Surgery. 2016; 23 (5):762-768.

3. Magiorakos AP, Burns K, Baño JR, Borg M, Daikos G, Dumpis U, Lucet JC et al. Surgical site infection rates following cardiac surgery: the impact of a 6-year infection control program. Am J Infect Control. 2005; 33(8):450-454.

4. Pittet D, Hugonnet S, Harbarth S, Mourouga P, Sauvan V, Touveneau S et al. Effectiveness of a hospital-wide programme to improve compliance with hand hygiene. Infection Control Programme. Lancet. 2000; 356(9238):1307-1312.

5. Morgan D, Rogawski E, Thom KA, Johnson JK, Perencevich EN, Shardell M et al. Transfer of multidrug-resistant bacteria to healthcare workers' gloves and gowns after patient contact increases with environmental contamination. Crit Care Med. 2012; 40(4):1045-1051.

6. Abboud CS, de Souza EE, Zandonadi EC, Borges LS, Miglioli L, Monaco FC et al. Carbapenem-resistant Enterobacteriaceae on a cardiac surgery intensive care unit: successful measures for infection control. J Hosp Infect. 2016; 94(1):60-64.

Volume 3, Number 57 (2020)