First Report of German Cockroaches (Blattella germanica) as Reservoirs of CTX-M-15 Extended-Spectrum-β-Lactamase- and OXA-48 Carbapenemase-Producing Enterobacteriaceae in Batna University Hospital, Algeria

Abstract

Here we report the isolation of extended-spectrum ␤-lactamase (ESBL)-and carbapenemase-producing Enterobacteriaceae from German cockroaches caught in the burn unit of Batna University Hospital in Algeria. Nine of 12 isolates harbored the bla CTX-M-15 ESBL gene. One Enterobacter cloacae isolate belonging to sequence type 528 coexpressed the bla OXA-48 , bla CTX-M-15 , and bla TEM genes. Our findings indicate that cockroaches may be one of the most dangerous reservoirs for ESBL and carbapenemase producers in hospitals.T he emergence of multidrug-resistant Enterobacteriaceae (MDRE) and their dissemination in hospitals have become a major health concern worldwide (1). The production of ␤-lactamases such as extended-spectrum ␤-lactamase (ESBL) and carbapenemase remains the main mechanism of resistance in Enterobacteriaceae (2). Algeria is now feaures among the Mediterranean countries known to be affected by the spread of CTX-M-15 type ESBL and the emergence of the phantom menace OXA-48 type carbapenemase (3, 4). Indeed, the transmission and dissemination of MDRE in hospitals are usually related to hand contact (5) and poorly sterilized instruments (6). However, cockroaches which colonize these environments may also act as potential mechanical vectors of antibiotic-resistant bacteria (7). Cockroaches are among the most prevalent pests in hospitals, where they are attracted by moisture, food, and suitable temperatures (8, 9). The medical significance of cockroaches has been largely overlooked, but it has been proven that they can harbor a number of pathogenic microorganisms with different levels of antibiotic resistance (10). Blattella germanica is the most abundant cockroach species (11), and the external surfaces and excrement of these cockroaches can contaminate food, human habitats, and hospital equipment; therefore, these insects can present a threat to human health (12).The aim of our study was to screen for broad-spectrum-cephalosporin-and carbapenem-resistant Enterobacteriaceae in B. germanica cockroaches collected from the burn unit of Batna University Hospital in Algeria and then to investigate the molecular support of ESBL and carbapenemase production.In March 2015, 10 cockroaches were randomly captured from different parts of the burn unit, including the kitchen and the guard, treatment, and patient rooms, directly in sterile containers. Samples were immobilized by freezing at 0°C for 10 min (8). Each cockroach was soaked in 5 ml of Tween 80 solution at 0.05% and vortexed vigorously for 2 min. The resulting wash was used as an external-body-homogenate sample. To remove the external body contamination, cockroaches were immersed in bleach for 2 min, in sterile physiological saline for 2 min, and then in 70% ethanol for 5 min (12). Then, each sample was washed with sterile physiological saline. Subsequently, the insect was soaked in a sterile bottle containing 5 ml of Tween 80 solution at 0.05% and then crushed inside using a sterile pestle. The triturate was then vortexed vigorously for 2 min. The resulting s...

Outbreak of OXA-48-Producing Klebsiella pneumoniae Involving a Sequence Type 101 Clone in Batna University Hospital, Algeria

“…These data, along with those of earlier studies and the more recent description of OXA-48-producing Enterobacteriaceae from companion animals and hospital cockroaches, confirm the widespread presence of OXA-48-producing Enterobacteriaceae in Algeria (29,30).…”

Household cockroaches carry CTX-M-15, OXA-48 and NDM-1, and share beta-lactam resistance determinants with humans

“…The direct transfer of AmpC-, ESBL-, or carbapenemase-producing bacteria to humans via insects seems possible, but evidence is sparse [24,35]. Loucif et al showed that 9 of 12 bacterial isolates from cockroaches in an Algerian hospital harboured CTX-M-15 genes.…”

“…Loucif et al showed that 9 of 12 bacterial isolates from cockroaches in an Algerian hospital harboured CTX-M-15 genes. Of these, one expressed an OXA-48 type carbapenemase and belonged to the sequence type 528 [24]. Elsewhere, Fotedar and colleagues indicated in an experimental study that insects fed with Pseudomonas aeruginosa could excrete the bacteria even up to 114 days post-infection[35].…”

“…Some of the pathogenic bacteria may be carriers of drug-resistance determinants, particularly beta-lactamases. However, only few studies have investigated AmpC, ESBL or carbapenemase resistance elements in bacteria from cockroaches[24]. Consequently, the vector potential of cockroaches in the dissemination of such multidrug-resistance mechanisms is largely under-reported.…”

First Detection of VIM-2 Metallo-β-Lactamase-Producing Pseudomonas putida in Blattella germanica Cockroaches in an Algerian Hospital

“…Samples were subjected to the bacterialsuspension preparation and preenrichment as previously described (5). Subsequently, selective enrichment was performed in a vancomycin-and ertapenem-supplemented brain heart infusion broth (BD, France) (5).…”