High incidence of MBL-mediated imipenem resistance among Pseudomonas aeruginosa from surgical site infections in Egypt

Raouf, Marian R; Sayed, Mohamed; Rizk, Hazim A; Hassuna, Noha A.

doi:10.3855/jidc.9936

Cited by 10 publications

(5 citation statements)

References 33 publications

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“…aeruginosa were MBL-producing isolates with 29% of them harboring the bla VIM gene. 16 Therefore, carbapenems can be effective treatment options in E. coli isolates in our hospitals, which is in agreement with the recent report. 17 One of the significant findings of this study is the resistance to carbapenem found in isolates obtained from in-patients in Balsam Hospital and Al-Shifa Hospital.…”

Section: Discussionsupporting

confidence: 91%

First report of VIM metallo-β-lactamase production in Escherichia coli and Klebsiella pneumoniae clinical isolates from Gaza Strip, Palestine

Tayh

Nagarjuna

Sallem

et al. 2020

Germs

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Introduction Even though the increasing incidence of VIM-producing E. coli and K. pneumoniae has been reported worldwide, studies are still lacking in Palestine. The aim of this study was to screen carbapenem-resistant E. coli and K. pneumoniae bacteria in the Gaza Strip, Palestine and further to characterize carbapenemase-producing isolates.Methods A total of 69 E. coli and 27 K. pneumoniae isolates were obtained from three Gaza hospitals and recovered from urine, wound swabs, blood and ear discharge. The screening for metallo-βlactamases (MBLs) was performed by using the imipenem-EDTA disc synergy test. The detection of βlactamases genes, detection of non-β-lactam genes and the characterization of integrons were performed by PCR and sequencing. The clonal relationship among the isolates was determined by pulsed-field gel electrophoresis (PFGE).Results Our study showed that 4 E. coli (5.8%) and 5 K. pneumoniae (18.5%) were positive by the imipenem-EDTA disc synergy test. Bla VIM-4 was detected in six isolates and bla VIM-28 was identified in three isolates. The β-lactamases genes in the VIM-producing K. pneumoniae isolates were bla CTX-M-15 (n=3), bla CTX-M-14 (n=1), bla SHV-1 (n=3), bla SHV-12 (n=1), bla TEM-1 (n=1) and bla OXA-1 (n=1). Aac(6′)-Ib-cr gene was confirmed in four E. coli and in two K. pneumoniae isolates. QnrS1 was identified in two K. pneumoniae isolates. The class 1 integron was identified with the different gene cassette; dfrA17-aadA5, dfrA5, dfrA12-orf-aadA2 and dfrA17-aadA5 were identified. ConclusionsOur study indicated for the first time the emergence of multidrug-resistant VIMcontaining K. pneumoniae and E. coli isolates of clinical origin in Gaza Strip hospitals.

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Section: Discussionsupporting

confidence: 91%

First report of VIM metallo-β-lactamase production in Escherichia coli and Klebsiella pneumoniae clinical isolates from Gaza Strip, Palestine

Tayh

Nagarjuna

Sallem

et al. 2020

Germs

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“…26 In the current study, MDR P.aeruginosa showed a frequency of 22.5%, which is far less than previous results found in the same region. 18 These could be due to differences in the nature of infection with different associated risk factors. 27 In addition to the fact that the epidemiology of MDR microorganism infections fluctuates from year to year between hospitals, wards, departments in addition to the geographical zone.…”

Section: Discussionmentioning

confidence: 99%

“…16 In previous studies done in this region, a high incidence of MDR P. aeruginosa was observed among isolates from infected burn and surgical wounds. 17,18 The identification of virulence genes' profile is crucial for developing efficient policies against P. aeruginosa infections; the aim of this study was to evaluate the distribution of different virulence genes among MDR P. aeruginosa isolated from different Egyptian ICUs.…”

Section: Introductionmentioning

confidence: 99%

<p>Virulence Constitution of Multi-Drug-Resistant <em>Pseudomonas aeruginosa</em> in Upper Egypt</p>

Hassuna¹,

Mandour²,

Mohamed³

2020

IDR

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Ventilator-associated pneumonia caused by Pseudomonas aeruginosa (P. aeruginosa) is a major health-care problem. In this study, we explored the epidemiology of virulence determinants among multi-drug-resistant (MDR) clinical P. aeruginosa isolates from hospitalized patients with ventilator-associated pneumonia in intensive care units in Upper Egypt. Patients and Methods: MDR P. aeruginosa isolates were screened for the presence of eight virulence factors and typed by ERIC-PCR. Results: A total of 39 clinical MDR isolates were selected out of 173 isolated P. aeruginosa showing a combination of adhesion and cytotoxicity virulence patterns, with the detection of aprA, exoU, exoS, lasB, algD, toxA in 74.3%, 58.9%, 46.1%, 41.2%, 30.7%, 20.5% of the isolates, respectively. The MDR isolates were grouped into 13 different virulence profiles according to the pattern of virulence gene distribution. exoU genotype was more predominant among the P. aeruginosa isolates with more than 48% of the isolates harboring this gene alone, 7% harboring both exoU and exoS and 43.5% harboring exoS gene. An intermediate degree of diversity was detected by ERIC-PCR typing where the isolates were clustered in 7 major groups, indicating possible cross-infection within the hospital. Conclusion: Our results highlight the increased frequency of virulent P. aeruginosa isolates with a shift to the more virulent cytotoxic exoU genotype. Further hospital infection-control measures are mandatory to control the hospital cross-transmission of these highly virulent isolates. This study could vastly be a help to develop efficient treatment policies against P. aeruginosa induced ventilator-associated pneumonia.

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“…The strains used as positive control were obtained from previous studies isolates. The amplification reactions were carried out using Biometra, UNO II thermal cycler. PCR products were resolved on 2% agarose gel and visualised under a UV transilluminator (Biometra).…”

Section: Methodsmentioning

confidence: 99%

Multidrug‐resistant Klebsiella pneumoniae in hospital‐acquired infections: Concomitant analysis of antimicrobial resistant strains

et al. 2019

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Background Hospital‐acquired infections caused by K pneumoniae are difficult to eradicate since K pneumoniae carries resistance genes for many antimicrobials, including carbapenems. The study aimed to determine the prevalence of hospital‐acquired infections caused by multiple drug‐resistant K pneumoniae and identify carbapenem and fluoroquinolone resistance by phenotypic and genotypic methods amongst hospitalised patients. Methods Two hundred and fifty samples from patients with hospital‐acquired infections were included. Identification and susceptibility testing for K pneumoniae isolates was performed by standard methods. The detection of carbapenemase resistance (blaKPC, blaVIM‐1 and blaOXA‐48) and plasmid‐mediated quinolone resistance (PMQR; qnrA, qnrB and qnrS) genes was performed using PCR assay. Results Out of 250 samples, 42 (16.8%) were multiple drug‐resistant K pneumoniae, and the frequency of K Pneumoniae isolation was higher in urine samples, in the age group (<10 years), in ICU and in patients with longer hospital stay. Twenty‐four (57%) of the isolates were resistant to Meropenem, 13 (31%) were resistant to Imipenem and 35 (83.3%) were resistant to Ciprofloxacin. blaOXA‐48 gene was detected in 9 (21.4%) of isolates, and blaVIM‐1 gene was detected in 6 (14.3%) of isolates. However, no isolate harboured blaKPC gene. PMQR genes were detected in 100% of ciprofloxacin resistant isolates, and qnrS was the dominant. Conclusion Multidrug‐resistant K pneumoniae isolates harbouring blaOXA‐48, blaVIM‐1 and PMQR genes are emerging in hospitals particularly with long hospital stays.

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High incidence of MBL-mediated imipenem resistance among Pseudomonas aeruginosa from surgical site infections in Egypt

Cited by 10 publications

References 33 publications

First report of VIM metallo-β-lactamase production in Escherichia coli and Klebsiella pneumoniae clinical isolates from Gaza Strip, Palestine

First report of VIM metallo-β-lactamase production in Escherichia coli and Klebsiella pneumoniae clinical isolates from Gaza Strip, Palestine

<p>Virulence Constitution of Multi-Drug-Resistant <em>Pseudomonas aeruginosa</em> in Upper Egypt</p>

Multidrug‐resistant Klebsiella pneumoniae in hospital‐acquired infections: Concomitant analysis of antimicrobial resistant strains

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