Double Trouble: Tackling Dual Carbapenemase Producing Bacteria in Resource-Limited Settings

Session Description: The rise and global spread of redundant carbapenemase-producing bacteria that carry double or multiple carbapenemase enzymes poses a new and concerning phenomenon. Simultaneous carriage of more than one carbapenemase can potentially give rise to carbapenem-resistant strains with wider hydrolytic capacity to carbapenems and a broader antibiotic resistance profile, substantially decreasing the already limited treatment options.

While the problem is global, with reports from Asia, Europe, North America, South America, and Africa, low- and middle-income countries (LMICs) face unique challenges. The real burden is probably underestimated due to limited laboratory resources for genomic surveillance. These diagnostic gaps, combined with infection prevention and control (IPC) challenges such as workforce shortages and limited supplies, facilitate the silent, undetected spread of these resistant organisms. Our session will feature new findings from a systematic review highlighting the global and regional prevalence of double and multiple carbapenemase-producing bacteria, emphasizing their clinical and epidemiological impact.

In this session, we will also share a real-world experience from a resource-limited intensive care unit where we successfully implemented a set of low-cost, coordinated IPC strategies to address endemic transmission of these organisms. Key interventions included targeted education on hand hygiene and contact precautions, use of visual alerts to prompt safe practices, cohorting strategies, intensified environmental cleaning, and staff engagement through case discussions. We tracked the dissemination and relatedness of isolates using affordable molecular monitoring tools to gain a better understanding of local transmission dynamics. This coordinated approach improved IPC culture and team involvement while reducing transmission rates.

By attending this session, infection preventionists, microbiologists, clinicians, epidemiologists, and policymakers will gain valuable insights into how to recognize, respond to, and mitigate the impact of these superbugs. This session promotes equitable access to infection control knowledge and supports the development of adaptable, inclusive strategies for diverse healthcare settings.

Hager Mewafy

Lecturer of Medical Microbiology and Immunology, Faculty of Medicine, Cairo University

Dr. Hager Mewafy, MD, CIC, is an Infection Control Consultant at Cairo University Hospitals and a Lecturer in Medical Microbiology and Immunology at Cairo University. With over 10 years of experience in clinical microbiology, infection prevention, and antimicrobial stewardship, she leads infection control initiatives in critical care, oversees hospital-acquired infection surveillance, and develops protocols to enhance patient safety. She holds an MD and MSc in Medical Microbiology and Immunology and is pursuing a fellowship in infection control to further deepen her expertise. Dr. Mewafy is certified in infection control (CIC®) since 2023 and an active member of the Association for Professionals in Infection Control & Epidemiology. Her research focuses on antimicrobial resistance, carbapenem-resistant organisms, and innovative disinfection strategies, with multiple peer-reviewed publications. She is passionate about advancing evidence-based infection prevention, fostering global collaboration, and combating antimicrobial resistance and healthcare-associated infections.

Yoojin Kim

Director of Infection Prevention and Control, OHSU

Yoojin Kim has worked as an Infection Preventionist since 2015 and currently serves as Director of Infection Prevention at Oregon Health & Science University, a leading academic medical center. Her primary focus is reducing the risk of infectious organism transmission across healthcare environments and deeply appreciates the continuous learning required to effectively adapt to emerging risks and evolving healthcare practices. She holds a PhD in Microbiology and is board-certified in infection control. Yoojin is also a member of Oregon’s Healthcare-Associated Infections Advisory Committee (HAIAC) and Oregon Health Authority: Statewide Taskforce for Antimicrobial Resistance (STAR) Program. She has been an active contributor to her local APIC chapter since 2017, serving in leadership roles including President, Board Director, and Chair and Co-Chair of education conferences. Since 2024, she has also served on the APIC Membership Engagement Committee (MEC).