Carbapenem-resistant gram-negative bacilli in Tripoli, Libya

Kraiem, Abdulmajeed Ghanem; Zorgani, Abdulaziz; Elahmer, Omar; Salabi, Allaaeddin Ali El; Ghenghesh, Khalifa Sifaw

doi:10.1016/j.ajic.2016.04.245

Cited by 3 publications

(3 citation statements)

References 10 publications

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“…In our study, high resistance rates were found in P. aeruginosa isolates against different antipseudomonal antibiotic classes (ceftazidime, piperacillin-tazobactam, ciprofloxacin and amikacin), with resistance rates ranging from 48.9% to 75.6%. This elevation in resistance rates was observed in a previous study in Libya, which was performed on 45 clinical P. aeruginosa isolates collected between October 2013 and May 2014 [ 28 ]. In their study, the resistance rates for the same antibiotics ranged from 76% to 95%.…”

Section: Discussionsupporting

confidence: 71%

“…A study to phenotypically screen for carbapenemase-resistant metalo-beta-lactamase in P. aeruginosa isolates collected from patients in Burn and Plastic Surgery Center, Tripoli, had detected these enzymes in 32.6% of the isolates [ 28 ]. However, compared to a nearby country, Egypt, Azab et al , (2015) studied 45 clinical strains of P. aeruginosa isolated from cases of surgical site infections [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

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Antimicrobial resistance and carbapenemase dissemination in Pseudomonas aeruginosa isolates from Libyan hospitals: a call for surveillance and intervention

Gadaime,

Haddadin,

Shehabi

et al. 2024

Libyan Journal of Medicine

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Pseudomonas aeruginosa is a multidrug-resistant bacterium capable of forming biofilms. This study aimed to assess resistance of clinical isolates from Libyan hospitals to antipseudomonal antibiotics, the prevalence of selected extended-spectrum β-lactamases and carbapenemase genes among these isolates, and the microorganisms’ capacity for alginate and biofilm production. Forty-five isolates were collected from four hospitals in Benghazi and Derna, Libya. Antimicrobial susceptibility was determined using agar disc diffusion. The presence of resistance genes ( bla CTXM , bla TEM , bla SHV-1 , bla GES-1 , bla KPC , and bla NDM ) was screened using PCR. Biofilm formation was quantified via the crystal violet assay, while alginate production was measured spectrophotometrically. Resistance to antipseudomonal antibiotics ranged from 48.9% to 75.6%. The most prevalent resistance gene was blaNDM (26.7%), followed by blaGES-1 (17.8%). Moreover, all isolates demonstrated varying degrees of biofilm-forming ability and alginate production. No statistically significant correlation was found between biofilm formation and alginate production. The dissemination of resistant genes in P. aeruginosa, particularly carbapenemases, is of great concern. This issue is compounded by the bacteria’s biofilm-forming capability. Urgent intervention and continuous surveillance are imperative to prevent further deterioration and the catastrophic spread of resistance among these formidable bacteria.

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Section: Discussionsupporting

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Antimicrobial resistance and carbapenemase dissemination in Pseudomonas aeruginosa isolates from Libyan hospitals: a call for surveillance and intervention

Gadaime,

Haddadin,

Shehabi

et al. 2024

Libyan Journal of Medicine

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“…These two studies illustrate the fact that the bla OXA-48 gene is circulating in Libya and in its neighboring countries. In 2013–2014, 32 carbapenem-resistant K. pneumoniae were reported in two Tripoli hospitals but were not characterized molecularly [ 9 ]. A new level of resistance was reached in 2014–2015, with the emergence of K. pneumoniae belonging to different STs (ST11, ST15, ST101, ST147, ST405) and presenting the bla OXA-48 and/or the bla NDM-1 genes in a few cases, in addition to the rmtC gene conferring resistance to amikacin, or to insertions in the mgrB conferring resistance to colistin [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Clonal, Plasmidic and Genetic Diversity of Multi-Drug-Resistant Enterobacterales from Hospitalized Patients in Tripoli, Libya

Elgriw,

Métayer,

Drapeau

et al. 2023

Antibiotics

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Resistance to extended-spectrum cephalosporins (ESC) and carbapenems in Enterobacterales is a major issue in public health. Carbapenem resistance in particular is associated with increased morbidity and mortality. Moreover, such resistance is often co-harbored with resistance to non-beta-lactam antibiotics, and pathogens quickly become multi-drug-resistant (MDR). Only a few studies have been published on AMR in Libyan hospitals, but all reported worrisome results. Here, we studied 54 MDR isolates that were collected from 49 patients at the Tripoli University Hospital between 2019 and 2021. They were characterized using phenotypic methods, PCR and PFGE, and a sub-set of isolates were short- and long-read whole-genome sequenced. The results showed the frequent occurrence of Klebsiella pneumoniae (49/54), among which several high-risk clones were responsible for the spread of resistance, namely, ST11, ST17, ST101 and ST147. ESC and carbapenem resistance was due to a wide variety of enzymes (CTX-M, OXA-48, NDM, KPC), with their corresponding genes carried by different plasmids, including IncF-IncHI2 and IncF-IncR hybrids. This study highlights that implementation of infection prevention, control and surveillance measures are needed in Libya to fight against AMR.

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Molecular Epidemiology of Carbapenem-Resistant Acinetobacter baumannii Isolates from Northern Africa and the Middle East

Higgins

Hagen

Kreikemeyer³

et al. 2021

Antibiotics

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At the Bundeswehr Hospitals of Hamburg and Westerstede, patients repatriated from subtropical war and crisis zones of Northern Africa and the Middle East were medically treated, including microbiological assessment. Within a six-year interval, 16 Acinetobacter spp. strains, including 14 Acinetobacter baumannii (Ab) isolates with resistance against carbapenems and origins in Afghanistan (n = 4), Iraq (n = 2), Libya (n = 2), and Syria (n = 8) were collected. While clonal relationships of Libyan and Syrian strains had been assessed by superficial next generation sequencing (NGS) and “DiversiLab” repetitive elements sequence-based (rep-)PCR so far, this study provides core genome-based sequence typing and thus more detailed epidemiological information. In detail, sequencing allowed a definitive species identification and comparison with international outbreak-associated Ab strains by core genome multi locus sequence typing (cgMLST) and the identification of MLST lineages, as well as the identification of known resistance genes. The sequence analysis allowed for the confirmation of outbreak-associated clonal clusters among the Syrian and Afghan Ab isolates, indicating likely transmission events. The identified acquired carbapenem resistance genes comprised blaOXA-23, blaOXA-58, blaNDM-1, and blaGES-11, next to other intrinsic and acquired, partly mobile resistance-associated genes. Eleven out of 14 Ab isolates clustered with the previously described international clonal lineages IC1 (4 Afghan strains), IC2 (6 Syrian strains), and IC7 (1 Syrian strain). Identified Pasteur sequence types of the 14 Ab strains comprised ST2 (Syrian), ST25 (Libyan), ST32 (Iraqi), ST81 (Afghan), ST85 (Libyan), and ST1112 (Syrian), respectively. In conclusion, the study revealed a broad spectrum of resistance genes in Ab isolated from war-injured patients from Northern Africa and the Middle East, thereby broadening the scarcely available data on locally abundant clonal lineages and resistance mechanisms.

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Carbapenem-resistant gram-negative bacilli in Tripoli, Libya

Cited by 3 publications

References 10 publications

Antimicrobial resistance and carbapenemase dissemination in Pseudomonas aeruginosa isolates from Libyan hospitals: a call for surveillance and intervention

Antimicrobial resistance and carbapenemase dissemination in Pseudomonas aeruginosa isolates from Libyan hospitals: a call for surveillance and intervention

Clonal, Plasmidic and Genetic Diversity of Multi-Drug-Resistant Enterobacterales from Hospitalized Patients in Tripoli, Libya

Molecular Epidemiology of Carbapenem-Resistant Acinetobacter baumannii Isolates from Northern Africa and the Middle East

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