Phenotypic and Genotypic Detection of Carbapenem Resistance in Urinary Enterobacterales Isolates: A Prospective Cross-Sectional Diagnostic Evaluation Study

This study highlights the growing prevalence of carbapenem-resistant Enterobacteriaceae (CRE) in urinary tract infections, driven mainly by carbapenemase enzymes such as NDM and OXA-48-like, particularly in Escherichia coli and Klebsiella pneumoniae. Among 350 isolates, 110 were confirmed as carbapenem-resistant by PCR, underscoring significant resistance levels. While the Carba-NP test showed high specificity, its lower sensitivity compared to multiplex PCR indicates that molecular diagnostics are essential for accurate detection. The findings stress the urgent need for rapid identification, targeted therapy, and strengthened antimicrobial stewardship and infection control to limit the spread of these highly resistant pathogens.